电子支气管镜检查对老年痰菌阴性疑似肺结核的诊断价值

Clinical significance of electronic bronchoscopy in elderly sputum negative pulmonary tuberculosis

目的探讨电子支气管镜对老年痰菌阴性疑似肺结核的诊断价值。方法选择2013-04至2017-04武警新疆总队医院收治的60例老年痰菌阴性疑似肺结核临床资料进行回顾性分析。结果纤维支气管镜刷检(简称刷检)阳性37例(61.67%),灌洗液阳性32例(53.33%),活检阳性34例(28.33%),其中活检和刷检均阳性的有19例(31.67%),灌洗阳性率与刷检阳性率比较,差异无统计学意义(χ2=3.01,P=0.07),刷检联合灌洗阳性率高于刷检或灌洗阳性率,差异均有统计学意义(χ2分别为11.59和24.60,P均<0.05)。结论老年肺结核的临床症状不典型,行支气管镜下灌洗、刷检对菌阴肺结核具有一定诊断价值,有条件应尽早做支气管镜检查。

Objective To investigate the value of electronic bronchoscopy in the diagnosis of sputum bacteria resistant pulmonary tuberculosis in the elderly. Methods The clinical data of 60 elderly patients with suspected sputum negative bacterial tuberculosis treated in our hospital was analyzed retrospectively. Results Brush biopsy was positive in 37 cases（61. 67%）,lavage fluid in 32 cases（53. 33%）,biopsy in 34 cases（28. 33%）,including 19 cases（31. 67%） whose biopsy and brush biopsy were both positive.There was no statistically significant difference（χ2= 3. 01,P = 0. 07） between the positive rate of lavage fluid and that of brush lavage.The positive rate of brushing combined with BALF was higher than that of brushing or BALF alone,and the difference was statistically significant（χ2 respectively 11. 59 and 24. 60,all P 0. 05）. Conclusions The clinical symptoms of senile pulmonary tuberculosis are not typical. Bronchoscopy and brushing tests are of diagnostic value for bacterial negative pulmonary tuberculosis,and bronchoscopy should be performed as early as possible.