摘要
目的:探讨肺结核并发气管支气管结核(TBTB)的影像学特点与支气管镜下表现的关系,提高TBTB的早期发现率。方法:对2011年7月至2012年2月经支气管镜检查明确诊断为TBTB的330例住院肺结核患者的影像学特点与支气管镜下所见的病变特征进行比较分析。结果:330例患者空洞型肺结核188例(57.0%),空洞常见右上叶99例(52.6%)、左上肺固有叶89例(47.3%)、左下叶51例(27.1%);肺不张77例(23.3%)。结核侵犯气道部位是气管35例(10.6%)、右上支气管131例(39.7%)、右中叶支气管30例(9.1%)、右下叶支气管50例(15.2%)、右主支气管30例(9.1%)、左上支固有支气管121例(36.7%)、左上舌叶支气管23例(6.7%)、左下支气管103例(31.2%)、左主支气管60例(18.2%)。TBTB分型炎症浸润型152例(46.1%)、溃疡坏死型19例(5.8%)、肉芽增殖型91例(27.6%)、瘢痕狭窄型68例(20.6%)。空洞和肺不张分别与TBTB受累部位和分型存在相关性(P<0.001);空洞型肺结核合并炎症浸润型为主;非空洞型肺结核合并肉芽增殖型为主(P<0.001);肺不张合并瘢痕狭窄型为主(P<0.001)。结论:对空洞型肺结核和肺不张及早进行支气管镜检查有助于TBTB的早期发现。
Objective To explore the correlation between radiological characteristics and bronchoscopy manifestation in patients with pulmonary tuberculosis （PTB） combined with tracheobronchial tuberculosis （TBTB）, and to improve the rate of early detection of TBTB. Methods Three hundred and thirty patients with PTB and TBTB in our hospital from Jul 2011 to Feb 2012 were included. The radiological characteristics, bronchoscopy manifestation and their correlation were analyzed. Results Among the 330 patients, 188 patients had cavity in lung （57.0%）, of which, 99 cases had cavity located in the upper right lobe （52.6%）, 89 cases had that located in the upper left lobe （47.3%）, and 51 cases in the lower left lobe （27.1%）. 77 patients had atelectasis （23.3%）. 35 cases had TBTB in trachea （10.6%）, 131 cases had that in upper right bronchial （39.7%）, 30 cases in right middle bronchus （9.1%）, 50 in right lower lobe bronchus （15.2%）, 30 in right main bronchus （9.1%）, 121 in upper left inherent bronchial （36.7%）, 23 in upper left ligule bronchial （6.7%）, 103 in left lower bronchial （31.2%）, and 60 in left main bronchus （18.2%）. According to the typing of TBTB, 152 cases were inflammatory hyperaemia （ I ） （46.1%）, 19 cases were cheesy necrosis and mucosal ulceration （ 11 ） （5.8%）, 91 were hyperplastic polyp （ II1 ） （27.6%）, and 68 were bronchostenosis （1V）（20.6%）. The cavity and atelectasis were related to the TBTB affected parts and TBTB types （P 〈 0.001 ）. The PTB with cavity was mainly combined with inflammatory hyperaemia type, PTB with no cavity was mainly combined with hyperplastic polyp type （P 〈 0.001 ）, and PTB with atelectasis was mainly combined with bronchostenosis type （P 〈 0.001）. Conclusion The bronchoscopy can help to find TBTB for the PTB with cavity or atelectasis early.
出处
《实用医学杂志》
CAS
北大核心
2013年第23期3815-3818,共4页
The Journal of Practical Medicine
基金
广东省医学科研项目(编号:A2011497)
广州市卫生局科研项目(编号:201102A213156)
关键词
结核
肺
气管支气管
空洞
影像
支气管镜
Tuberculosis, pulmonary
Tracheobronchial
Cavity
Radiology
Bronchoscopy
