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目的探讨纤维支气管镜检查在支气管内膜结核诊断的价值。方法回顾性分析18例胸片正常的支气管内膜结核患者的临床表现、诊断和治疗。结果支气管内膜结核误诊率高,以女青年多见,病变多累及左主支气管、两肺上叶,症状主要包括:咳嗽(18例),胸闷气促(11例),发热(3例),咯血(2例),纤维支气管镜检查示炎症浸润型病变8例,增殖型病变5例,溃疡型病变2例,非特异性支气管炎型2例,狭窄闭塞型病变1例,均行黏膜活检和刷检,经黏膜活检病理确诊8例,活检细菌学证实12例,二者联合确诊18例。全身抗结核化疗后症状缓解率达100%。结论纤维支气管镜检查对气管支气管内膜结核有重要诊断价值。
Objective To investigate the value of bronchoscopy in the diagnosis of bronchial tuberculosis. Methods The clinical manifestations, diagnosis and treatment of 18 cases of normal chest endometrial tuberculosis were retrospectively analyzed. Results The misdiagnosis rate of endobronchial tuberculosis was high, more common in young women, and the lesion involved the left main bronchus and the upper lobes of both lungs. The symptoms mainly included cough (18 cases), chest tightness and irritability (11 cases) and fever (3 cases) , Hemoptysis (2 cases), fibrobronchoscopy showed infiltration of inflammatory lesions in 8 cases, proliferative lesions in 5 cases, ulcerative lesions in 2 cases, nonspecific bronchitis in 2 cases, stenosed occlusive lesions in 1 case, performed mucosal biopsy And brush test, the pathological diagnosis of mucosal biopsy in 8 cases, 12 cases confirmed by biopsy, the two were diagnosed in 18 cases. Systemic anti-tuberculosis chemotherapy symptoms remission rate of 100%. Conclusion Fiberoptic bronchoscopy has important diagnostic value for tracheobronchial endometrial tuberculosis.