支气管镜联合CT引导肺穿刺活检对痰涂阴性肺结核的诊断价值

Diagnostic value of bronchoscopy combined with CT guided cutting the needle lung biopsy on sputum smear negative pulmonary tuberculosis

目的评价联合使用多种介入诊断技术对于痰涂阴性肺结核诊断的价值。方法收治的62例通过介入技术确诊的痰涂阴性肺结核病例进行总结和分析。结果 62例痰涂阴性肺结核病例,通过支气管镜直视下行冲洗、刷检、活检,阳性检出率为43.5%,加做支气管镜肺活检后,阳性检出率为59.7%;有22例接受了CT引导下肺穿刺活检,阳性检出率为81.8%;支气管镜联合CT引导下肺穿刺活检的总阳性检出率88.7%。结论支气管镜检查和CT引导下经皮肺穿刺活检对于痰涂阴性肺结核的诊断具有重要价值,联合使用可显著提高阳性检出率。

Objective To evaluate the value of using a variety of interventional diagnostic techniques in combination for the diag- nosis of sputum smear-negative pulmonary tuberculosis. Methods A retrospective analysis of 62 sputum smear-negative TB cases diagno- sis by interventional technology from January 2008 to December 2011. Result Through the combined use of bronchial washing fluid smear, bronchial brush smear, and bronchial pathological biopsy, the positive diagnosis rate of 62 sputum smear-negative TB cases was 43.5%. With the addition of tranbronchil lung biopsy, the positive diagnosis rate was increased to 59.7%. 22 sputum smear-negative TB cases underwent CT-guided cutting the needle lung biopsy, and the positive diagnosis rate was 81.8%. The positive diagnosis rate in- creased to 88.7% when CT-gnided cutting the needle lung biopsy was combined with bronchoscopy. Conclusion Bronchoscopy, and CT-guided cutting the needle lung biopsy are effective in diagnosis of sputum smear-negative pulmonary tuberculosis. Their combined use can significantly increase the positive diagnosis rate.