15例儿童支气管结核的误诊分析

Misdiagnosis of bronchial tuberculosis in 15 children cases

目的提高对儿童支气管结核的认识，减少误诊。方法对误诊的儿童支气管结核，就其临床症状、胸部影像学表现、发病部位及镜下表现进行回顾性分析，同时进行典型病例的分析。结果15例儿童支气管结核被误诊的中位时间是3个月；主要表现为慢性咳嗽，因此易被误诊为哮喘、慢性支气管炎；支气管结核分型以溃疡坏死型和炎症浸润型为主，部位多见于上叶及下叶背段。结论儿童支气管结核的临床症状及影像学表现缺乏特异性，易被误诊，在临床诊疗中需要提高警惕，引起临床医师的重视，尽早的行气管镜检查明确诊断。

Objective To strengthen the understanding of bronchial tuberculosis in children and reduce misdiagnosis. Methods The clinical symptoms, chest imaging findings, site of disease and microscopic manifestations of 15 children with bronchial tuberculosis misdiagnosed were analyzed retrospectively. Besides, we shared a typical case. Results The median time of misdiagnosis in 15 children with endohronchial tuberculosis was 3 months. The main manifestations were chronic cough and expectoration, so they were often misdiagnosed as asthma and chronic bronchitis. The types of bronchial tuberculosis were mainly ulcerative necrosis and inflammatory infiltration, its site were often found in the upper and lower lobes. Conclusions The clinical symptoms and imaging findings of endobronehial tuberculosis in children are lack of specificity, so they are easily misdiagnosed. In clinical diagnosis and treatment, we should pay attention to it and arouse the attention of clinicians. In clinical diagnosis and treatment, attention should be paid to the attention of clinicians. Bronchoscopy should be done as early as possible to make a definite diagnosis.