1271例支气管结核临床特征和纤支镜检查结果的分析

Analysis of clinic characteristics and the flexible bronchoscopy results of 1271 cases with endobronchial tuberculosis

目的分析1271例支气管结核的临床发病特征和纤支镜检查结果 ,加强对支气管结核的认识,提高其诊断的准确性。方法总结并分析经纤维支气管镜发现的1271例支气管结核病例的临床特征和检查结果。结果 1271例病例中,女性病例多于男性(1.19:1),20～29岁年龄段女性多于男性(1.77:1),老年病例男性多于女性(2.04:1)。镜下观:右上支气管结核最多(397例,31.24%),其次是左上支气管结核(304例,23.92%),左主支气管结核(171例,13.45%)多于右主支气管(72例,5.66%),结核所致左主支气管狭窄(50例,39.68%)多于右主支气管(12例,9.52%),混合型(Ⅱ+Ⅲ)支气管结核最多,Ⅰ和Ⅳ型支气管结核相对较少,支气管结核引起肺不张右侧(111例,58.12%)多于左侧(81例,42.41%),以右上肺为最多(75例,39.27%),其次为左上肺(32例,16.75%),但全肺不张左侧多于右侧(23:2)。结论支气管结核的发病女性多于男性,年青女性明显多于男性,老年男性明显多于女性。支气管结核对支气管和肺的损伤大,支气管各部位的结核发病状况和损伤程度与其解剖结构的特殊性有一定的相关性。纤维支气管镜检查(直视和标本的获取)是诊断支气管结核的最好方法之一。

[Objective] To analyze the clinic characteristics and the flexible bronchoscopy results of 1271 cases with endobronchial tuberculosis.[Methods] The clinic characteristics and the flexible bronchoscopy results of 1271 cases with endobronchial tuberculosis were summarized and analyzed.[Results] In the 1271 cases with bronchial tuberculosis,the cases of female were more than the male （1.19：1）.In the age segment of 20 to 29,the cases of female were much more than the male （1.77：1）.In the elderly cases,the cases of male were much more than the female （2.04：1）.Bronchoscopy directly finding：The cases of the bronchial tuberculosis on the right upper bronchus were the most （397 cases,31.24%）,the secondary was the left upper bronchus （304 cases,23.92%）.The cases of the left main bronchus tuberculosis （171 cases,13.45%） were much more than the right main bronchus （72 cases,5.66%）.The left main bronchial stenosis （50 cases,39.68%） due to bronchial tuberculosis were more than the right main bronchus （12 cases,9.52%）.Mixed type （Ⅰ＋Ⅲ） bronchus tuberculosis was the most,type I and Ⅳ were relatively less.The atelectasis of right side lung due to bronchial tuberculosis was more than the left side lung,and the right upper lobe was the most （75 cases,39.27%）,the secondary was the left upper lobe （32 cases,16.75%）.The atelectasis of the left side lobe was more than the right side lobe （23：2）.[Conclusion] In the bronchial tuberculosis cases,female is more than male.In the younger,female is much more than male.In the elderly,much more male than female.Bronchial tuberculosis caused major damage to the bronchus and lung.Each part of the bronchial tuberculosis condition and damage degree has certain correlation on the particularity of the anatomical structure.Flexible bronchoscopy （bronchoscopy directly finding and obtaining a specimen） is one of the best method to diagnose bronchial tuberculosis.