支气管镜对隐匿性支气管结核的诊断与治疗(附22例报告)

Diagnosis and treatment of bronchoscope in bronchial tuberculosis

目的研究分析支气管镜对CT检查考虑单纯肺结核患者合并支气管结核的诊断价值。方法分析2009年1月～2010年12月期间来我院就诊的22例肺结核合并支气管结核患者的临床资料。结果 22例患者CT检查均未发现明显支气管狭窄及堵塞征象,临床表现为:顽固性咳嗽、大量排菌、肺部病灶变化大、痰菌难以转阴等;气管镜检查示炎症浸润型6例,溃疡及干酪坏死型8例,肉芽增生型6例。所有患者根据个人差异采取全身用药结合局部治疗,所有患者2个月内症状完全缓解,痰菌转阴,仅3例遗留轻度气管狭窄。结论对于CT检查考虑单纯肺结核患者,尽早行支气管镜检查,并早期干预。

Objective To analyze bronchoscope＇s application value in the diagnosis of bronchial tuberculosis which diagnosed as simply pulmonary tuberculosis by CT.Methods A retrospective analysis of clinical data of 22 cases with bronchial tuberculosis complicated with pulmonary tuberculosis in our hospital from Jan 2009 to Dec 2010 was made.Results Manifest bronchial stenosis or bronchial obstruct were not detected in all 22 patients by CT.The symptoms of the patients were refractoriness cough,mass acid-fast bacilli in sputum,pulmonary lesions changed diversity and sputum hard to turn negative.The results showed inflammatory infiltration change in 6 cases,ulcers and cheese necrosis change in 8 cases,and proliferation of granulation change in 6 cases under bronchoscope.All patients were taken systemic administration and part administration according to individual difference for 2 months,the symptoms of all patients resolved within 2 months,and sputum turned negative.Only 3 patients remained light bronchial stenosis.Conclusion When the patients diagnosed as simply pulmonary tuberculosis by CT appear symptoms mentioned above,it is critical to consider existence of bronchial tuberculosis and Taking bronchoscope examination and part administration early can improve prognosis.