纤维支气管镜检查对菌阴肺结核诊断的意义  

The Diagnostic Significance of Fibrebronchoscope in Pulmonary Tuberculosis Cases with Tubercle Bacillus Undetected

作　　者：许启霞[1] 陈余清[1] 刘超[1] 李翠侠[1] 黄礼年[1] 高华[1] 

机构地区：[1]安徽省蚌埠医学院第一附属医院呼吸内科,233004

出　　处：《中华全科医学》2009年第1期12-14,共3页Chinese Journal of General Practice

摘　　要：目的探讨纤维支气管镜(纤支镜)检查对菌阴肺结核的诊断意义。方法对菌阴肺结核患者123例纤支镜检查结果进行回顾性分析,了解镜下表现及组织活检病理、支气管刷检涂片和术后痰找抗酸杆菌对肺结核的诊断阳性率。结果本组病例中纤支镜下主要表现为管口或管腔瘢痕狭窄26.0%(32/123),黏膜表面有白色苔状物或豆腐渣样物覆盖21.2%(26/123),黏膜充血肿胀17.9%(22/123),肉芽肿样新生物17.1%(21/123),多发结节样新生物8.1%(10/123)。组织活检病理、支气管刷片以及术后痰涂片找抗酸杆菌检查,诊断肺结核的阳性率分别为75.5%(77/102),45.5%(56/123),38.2%(26/68),联合取材诊断率达100%。结论纤支镜检查是临床诊断菌阴肺结核的又一重要途径,组织活检病理、支气管刷片以及术后痰菌检查相互补充,可提高确诊率,减少误诊。Objective To investigate the diagnostic significance of fibrebronchoseope （ FB ） in pulmonary tuberculosis cases with tubercle bacillus undetected（uTB-PT）. Methods The results of FB examinations of 123 patients with uTB-PT were analyzed,in order to know the main presentations under BF and the positive rate of final diagnosis of pumonary tuberculosis （PT） about pathology and examination for acid-fast bacilli in the smear of bronchial brushing and sputum after FB. Results The main presentations were cieatricial constriction of tracheal lumen （26.0% , 32/123 ）, something like white moss or tofukasu covering tracheal mucous membrane（21.2% ,26/123 ）, mucosa swelling（ 17.9% ,22/123 ） ,granuloma（ 17.1% ,21/123 ）, multiple nodus （8.1% , 10/123 ）. The positive rates of pathologic diagnosis and examination of acid-fast bacilli in the smear of bronchial brush- ing and sputum after BF were respectively 75.5 % （77/102 ） ,45.5 % （56/123） ,38.2% （26/68）. Combined with the three ways, the positive rate was 100%. Conclusion BF is another important way to diagnose the uTB-PT. Pathologic examination, examination of acid-fast bacilli in the smear of bronchial brushing and sputum after BF are supplementary for improving the diagnosis rate and avoiding misdiagnose.

关 键 词：纤维支气管镜 菌阴肺结核 诊断 

分 类 号：R521[医药卫生—内科学]