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目的 探讨儿童支气管结核 (EBTB)的纤维支气管镜 (纤支镜 )诊断及分型。方法 回顾性总结、分析临床治疗不顺利的肺结核或可疑肺结核的住院患儿 110例 ,均经纤支镜诊查 ,归纳EBTB病变在纤支镜下表现 ,并分型为 :粘膜型、干酪型、管腔型和混合型。 110例均摄胸部X线片 (其中做胸部CT检查 6 2例 ) ,追踪临床诊疗过程和最终诊断 ,以验证纤支镜诊断。再评估纤支镜在儿童EBTB诊查中的作用 ,提出EBTB诊断标准。结果 纤支镜诊断 10 8例EBTB ,其中混合型 78例、粘膜型 18例、管腔型 9例、干酪型 3例。临床合并各型儿童肺结核 91例。在纤支镜确诊的 17例EBTB中 ,胸部X线片均未提供特异性结核证据 ,气道分泌物结核菌阳性 15例。本文结核菌阳性率为 5 3%。结论 儿童EBTB并非少见 ,其诊断在临床有重要意义 ;儿童EBTB可以原发 ;本文试行的儿童EBTB分型方法简便易行。纤支镜是诊断EBTB的必需工具。
Objective To investigate the diagnosis and classification of bronchial bronchoscopy (bronchofibroscopy) in children with bronchial tuberculosis (EBTB). Methods We retrospectively analyzed 110 cases of hospitalized children with tuberculosis or suspected pulmonary tuberculosis who were not cured clinically. All of them were diagnosed by fiberoptic bronchoscopy. The EBTB lesions were classified under bronchofibroscopy and classified as mucosal type, , Lumen and hybrid. 110 patients were taken chest X-ray (including chest CT examination of 62 cases), follow-up clinical diagnosis and treatment process and final diagnosis to confirm the diagnosis of bronchoscopy. Re-evaluate the role of fiberoptic bronchoscopy in the diagnosis of EBTB in children, proposed EBTB diagnostic criteria. Results Fiberoptic bronchoscopy was used to diagnose 108 EBTB cases, including 78 cases of mixed type, 18 cases of mucosal type, 9 cases of luminal type and 3 cases of cheese type. Clinical combination of 91 cases of various types of children with pulmonary tuberculosis. Among the 17 cases of EBTB diagnosed by bronchoscopy, none of the chest radiographs provided any evidence of specific tuberculosis, and 15 were positive for airway secretions. Mycobacterium tuberculosis positive rate of 53%. Conclusion EBTB is not uncommon in children and its diagnosis is clinically significant. EBTB in children can be primary. The EBTB typing method in this paper is simple and easy to perform. Bronchoscopy is an essential tool for diagnosing EBTB.