支气管镜检查对涂阴肺结核患者的诊断价值  

Diagnostic value of bronchoscopy in smear negative pulmonary tuberculosis

作　　者：董维维[1] 李润浦 王晓洁[1] 牛建明[1] 李丹华[1] 闫姗姗[1] 

机构地区：[1]保定市第二中心医院呼吸2科,河北省保定072750

出　　处：《中国基层医药》2016年第14期2179-2181,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨支气管镜检查对涂阴肺结核患者的诊断价值。方法回顾性分析空洞组65例及非空洞组35例涂阴肺结核患者的临床资料，经支气管镜取痰及术后取痰行痰涂片检查，比较两组及总体痰检阳性率。结果支气管镜检查空洞组、非空洞组及总体痰检阳性率分别为49．2％、17．1％、38．0％。空洞组与非空洞组痰检阳性率差异有统计学意义（χ2＝9．942，P ＝0．002）。术中取痰阳性率28．0％，术中取痰阴性、术后取痰阳性率10．0％。镜下可见气管、支气管异常改变，气管炎性改变率空洞组、非空洞组分别为52．3％、40．0％，两组差异无统计学意义（χ2＝1．381，P ＝0．240）；气管狭窄率空洞组、非空洞组分别为9．0％、11．4％，两组差异无统计学意义（χ2＝0．122，P ＝0．727）；总体气管异常改变率为58．0％，其中炎性改变率48．0％、狭窄率10．0％。结论支气管镜检查可明显提高痰检阳性率，且以肺部合并空洞性病变者为著，术后取痰可增加痰检阳性率，并可早期发现气管的异常改变。Objective To investigate the diagnostic value of bronchoscopy in smear negative pulmonary tuberculosis.Methods 65 cases with cavernous and 35 non -cavernous negative smear pulmonary tuberculosis were examined by bronchoscopy.Results The positive rates of sputum examination in the empty group,the non empty group and the total sputum examination were 49.2%,17.1% and 38%,respectively.There was statistically signifi-cant difference in sputum positive rate between empty group and non empty group （χ2 =9.942,P =0.002）.The posi-tive rate of sputum was 28%.The positive rate of sputum negative and sputum positive rate was 10% after operation. Microscopically visible tracheal and bronchial abnormalities,tracheal inflammatory change rates of empty group and non empty group were 52.3%,40.0%,the difference between the two groups had no statistically significant difference （χ2 =1.381,P =0.240）.The tracheal stenosis rates of hole group and non empty group were 9.0% and 11.4%,the difference between the two groups had no statistically significant difference （χ2 =0.122,P =0.727）.The overall trachea abnormal changes rate was 58.0%,including inflammatory change rate 48.0% and 10.0% stenosis rate. Conclusion Bronchoscopy has significant clinical value in smear negative pulmonary tuberculosis,especially with cavernous.The positive rate will be promoted after bronchoscopy,and can find abnormal changes of tube.

关 键 词：结核 肺 支气管镜检查 诊断 

分 类 号：R521[医药卫生—内科学]