淋巴结瘘型气管支气管结核的支气管镜下诊疗进展  

Progress in bronchoscopic diagnosis and treatment of lymph node fistula tracheobronchial tuberculosis

作　　者：罗莉 罗林紫 尹曲华 周磊 卢志斌 丁衍 肖阳宝 Luo Li;Luo Linzi;Yin Quhua;Zhou Lei;Lu Zhibin;Ding Yan;Xiao Yangbao(Endoscopy Center,Hunan Chest Hospital,Changsha 410013,China;Department of Radiology,Hunan Chest Hospital,Changsha 410013,China)

机构地区：[1]湖南省胸科医院内镜中心,长沙410013 [2]湖南省胸科医院放射科,长沙410013

出　　处：《中国防痨杂志》2025年第4期505-512,共8页Chinese Journal of Antituberculosis

基　　金：国家临床重点专科重大科研专项资助项目(Z2023075);湖南省临床医疗技术创新引导项目(2021SK50701)。

摘　　要：淋巴结瘘型气管支气管结核(tracheobronchial tuberculosis,TBTB)缺乏临床特异表现,通过支气管镜检查才能确诊,容易误诊和漏诊。近年来,随着支气管镜和支气管介入技术的普及和发展,淋巴结瘘型TBTB的检出率、治愈率明显提高。在全身抗结核药物治疗的基础上,支气管镜下局部药物灌注、冷冻、热消融、球囊扩张等治疗技术日渐丰富,针对淋巴结瘘型TBTB不同支气管镜下表现选择适当的综合介入疗法,已经成为临床治疗TBTB的有效辅助手段。笔者通过总结淋巴结瘘型TBTB支气管镜下表现的特点及介入治疗的疗效,以及近年来支气管镜下疗法的研究进展,对淋巴结瘘型TBTB的支气管镜下介入治疗策略进行综述,以期为淋巴结瘘型TBTB的镜下治疗提供快速有效的个体化方案。Lymph node fistula tracheobronchial tuberculosis(TBTB)lacks clinical specific manifestations and can only be diagnosed through bronchoscopy,which is prone to misdiagnosis and missed diagnosis.In recent years,with the popularization and development of bronchoscopy and bronchial intervention techniques,the detection and cure rates of lymph node fistula TBTB have significantly increased.On the basis of systemic anti-tuberculosis drug therapy,other treatment techniques,such as local drug infusion under bronchoscopy,freezing,thermal ablation,and balloon dilation etc.,are becoming increasingly diverse.Choosing an appropriate comprehensive intervention therapy based on different bronchoscopic manifestations of lymph node fistula TBTB has become an effective auxiliary means for clinical treatment of TBTB.This article is a review about the bronchoscopic interventional treatment strategies for lymph node fistula TBTB by reviewing the characteristics of bronchoscopic manifestations and the efficacy of interventional treatment methods for lymph node fistula TBTB,as well as the research progress of new bronchoscopic therapies in recent years.It is hopefully to provide some help on choosing a fast and effective endoscopic treatment with personalized care for patients with lymph node fistula TBTB.

关 键 词：结核 支气管疾病 淋巴结瘘 支气管镜检查 诊断技术和方法 

分 类 号：R52[医药卫生—内科学]