支气管镜检查对老年COPD合并肺结核患者的诊断价值

Diagnostic value of bronchoscope in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis

目的观察支气管镜检查在老年COPD合并肺结核患者诊断中的应用价值。方法分析142例老年COPD合并肺结核患者的临床资料,收集患者的痰涂片查抗酸杆菌结果,以及经支气管镜取支气管分泌物刷检涂片、支气管肺泡灌洗液(BALF)查抗酸杆菌、活检病理等检查结果,观察支气管镜检查对此类患者的诊断价值。结果老年COPD合并肺结核患者经支气管镜取支气管分泌物刷检涂片、BALF涂片、活检病理阳性率分别为44.4%,51.4%和60.6%,三种方法联合阳性率为100%,均显著高于痰涂片的阳性率21.8%(P<0.05)。结论经支气管镜刷检、BALF涂片联合活检可提高老年COPD合并肺结核患者的阳性诊断率。

Objective To explore the diagnostic value of bronehoscope in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis. Methods The clinical data of 142 patients with COPD complicated with pulmonary tuberculosis were analyzed, and the detection results of acid-fast bacilli in sputum smear, the secretion brush examination, and the broncho-alveolar lavage fluid （BALF）. The positive rates of the different diagnosis methods were compared. Results The positive rates of acid-fast bacilli examination in the smear of bronchial brushing, BALF and pathologic diagnosis were 44. 4% , 51.4% and 60. 6% respectively. The positive rate of the combination of the three ways was 100%. The positive rate of the three ways was significantly higher than that of sputum smear （P 〈0. 05 ）. Conclusion The combination method of brush examination, BALF and biopsy through broncho-scope can improve the positive rate of geriatric patients with COPD complicated with pulmonary tuberculosis.