支气管结核的临床纤维支气管镜分析  

Fiberoptic bronchoscopic clinic assessment of endobronchial tuberculosis

作　　者：黄信刚[1] 郑东元[1] 周淮英[1] 

机构地区：[1]中南大学湘雅二院呼吸内科,湖南长沙410011

出　　处：《中国内镜杂志》2005年第6期611-613,共3页China Journal of Endoscopy

摘　　要：目的总结分析支气管结核的临床特征以及纤维支气管镜对支气管结核的诊断价值。方法回顾性分析322例经纤维支气管镜检查、病理学和病原学检查确诊的气管、支气管结核病例。结果322例EBTB患者中,男性136例,占42.2%,女性186例,占57.8%;年龄15￣72岁,平均(33.8+9.3)岁,男∶女为1.00∶1.37。主要症状为咳嗽,占86.0%,咯血或痰中带血占25.8%,喘息或胸闷占18.0%,胸痛占10.9%,消瘦、乏力占6.8%。充血水肿型23.6%、溃疡坏死型36.0%、肉芽增殖型27.6%、瘢痕狭窄型12.7%。病变较多分布于左主支、左右上叶、右中间干等支气管,常累及多个支气管。确诊之前的初步诊断易误为肺炎、肺癌、支气管炎、哮喘、肺脓疡等。结论纤维支气管镜检查对支气管结核的诊断起关键性的作用,是避免漏诊、误诊的有效方法。[Objective] To analyse and summarize the clinic character of endobronchial tuberculosis(EBTB) and evaluate the importance of fiberoptic bronchoscope in the diagnosis of EBTB. [Methods] 322 cases of EBTB were analysed retrospectively, all the patients diagnosis was confirmed by fiberoptic bronchoscope, pathology and pathogeny. [Results] In 322 cases of EBTB, male patients 136 cases (42.2%), female patients 186 cases (42.2%), Female patients 186 cases (57.8%), average age was (33.8±9.3) year. They mostly symptom was cough (86.0%), emptysis(25.8%) gasp or chest depressed (18.0%), chest pain (10.9%) became thin and tired 6.8%, under the fiberotic bronchoscope, the type of congestion and edema in 23.6%, ulcerative lesions in 36%,granulomatons in 27.6% and scar straitness in 12.7%. The lesion usually take place in left main branch, both of the superior bronchus, sometimes involve multi-leaf bronchus. Beford diagnosis, it was usually mistook for pneumonia, lung cancer, bronchitis, asthma and so on. [Conclusion] Fiberoptic bronchoscope examination play a key role for the diagnosis of endobronchial tuberculosis, meanwhile, it is the best way to avoid mistaking diagnosis.

关 键 词：纤维支气管镜 支气管结核 诊断 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]