摘要
目的探讨单纯性支气管内膜结核的临床及纤维支气管镜下特点。方法回顾性分析本院经纤支镜检查后确诊单纯性支气管内膜结核66例的临床、X线和纤支镜下表现。结果主要症状为干咳,少数伴咳痰、咯血、发热、气急,体征有局限性干啰音,呼吸音减弱,少数呈广泛哮鸣音。X线表现为肺不张,肺内块状阴影,16例(24%)患者胸片无异常发现。纤支镜下所见分为浸润型,溃疡型,肉芽增殖型,疤痕型。钳检病理学阳性率62.7%,刷检物涂片抗酸杆菌阳性率74.6%。结论单纯性支气管内膜结核的临床症状与X线表现无特征性,纤支镜检查中联合活检组织病理及刷检物涂片抗酸杆菌检测是有效的诊断手段。
Objective To explore the clinical and bronchoscopic features of simple endobrenchial tuberculosis. Methods Clinical symptoms, chest X- - ay/CT manifestations and bronchoscopic findings of 66 cases with simple endobronchinal tuberculosis were retrospectively investigated. Results Main symptoms were as follows：cough, sputum production, fever, haemoptysis, and dyspnea. Clinical signs included localized rhonchi, decreased breath sounds, wheeze. Roentgenographic appearance were atelectasis in 31 （47%） and mass lesion in 19 （28.6%）. 16 patients （24. 2% ） had clear lung fields. Under fiberobrenchoscope, exudative lesions in 16 （24. 2% ）, ulceration lesions in 25 （37.9%）, granulomatous lesions in 17 （25.8%）, and cicatricial lesions in 8 （ 12. 1% ）. The successful detection rate of biopsy and brushing smear were 62.7% and 74. 6% respectively. Condusion The clinical manifestations and roentgenographic appearances of simple endobronchial tuberculosis are not specific. So bronchoscopy is mandatory for the prompt diagnosis, and bronchial biopsy and brushing smear examination for acid-fast bacillus are beneficial to rapid and definite diagnosis.
出处
《临床肺科杂志》
2010年第3期352-353,共2页
Journal of Clinical Pulmonary Medicine
