支气管结核248例临床分析

Clinical analysis of 248 cases of endobronchial tuberculosis

目的 探索气管、支气管结核的临床特征及诊断治疗手段。方法 分析 2 4 8例 1993～ 2 0 0 0年住院气管支气管结核病例资料临床表现、影像学、纤支镜检查 ,治疗结果。结果 2 4 8例患者中 15～ 34年龄组青年女性明显高于其它组占 6 9.2 % (72 / 10 4 )。左侧支气管病变多于右侧。影像学、纤支镜、实验室检查确诊 2 34例 ,肺切除术后病理确诊 14例。全组病例均予规范抗结核化疗 ,其中并用雾化治疗 72例。经纤支镜支气管腔内给药 2 6例有效率 84 .6 %。外科治疗 4 7例。结论 纤支镜检查是诊断气管支气管结核最重要的方法。在实施规范抗结核化疗同时并用雾化及经纤支镜支气管内给药治疗 ,是改善临床症状 ,减轻或消除支气管狭窄的有效方法。对不可逆结核性支气管狭窄。

Objectives To explore the clinical characteristic and diagnostic therapeutic measures for endobronchial tuberculosis.Method 248 cases of endobronchial tuberculosis admitted from 1993 to 2000 were analyzed based on clinical, photographic and bronchoscopic data.Results The age group of 15～34 female patients occupied 69.2% of the total and was significantly higher than other groups. The bronchial lesions located on left side were much more than on right side. The diagnosis was confirmed by photographic, bronchoscopic and laboratory examination in 234 cases. The diagnosis was confirmed by pathological examination of resected lung in 14 cases. All the cases were under standard anti-tuberculosis chemotherapy;72 cases were also treated with aerosol treatment and 26 cases were also treated by intra-bronchial injection. The overall effective rate was 84.6%. Conclusion Bronchscopic examination was the most important procedure for the diagnosis of endobronchial tuberculosis. Beside the standard chemotherapy of anti-tuberculosis drugs, combined treatment of aerosol and intra-bronchial injection were very useful for relieving clinic symptoms, reducing or eliminating the stricture of bronchus. Surgical operation on time was indicated on patients with un-reversible stricture of bronchus, atelectasis and serious insufficiency of pulmonary functions.