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目的探讨纤维支气管镜检查在支气管结核诊断中的价值。方法回顾性分析22例胸片正常的支气管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,以青年女性多见,病变多累及左主支气管、两肺上叶,纤维支气管镜检查示炎症浸润型病变12例,干酪坏死型病变5例肉芽增生型型病变3例,纤维狭窄型病变2例,均行黏膜活检和刷检,经黏膜活检病理确诊16例,刷检细菌学证实9例,两者联合确诊22例。全身抗结核化疗后症状缓解率达100%。结论纤支镜检查对气管支气管结核有重要诊断价值。
Objective To investigate the value of fiberoptic bronchoscopy in the diagnosis of bronchial tuberculosis. Methods The clinical manifestations, diagnosis and treatment of 22 patients with normal chest X-ray of bronchial tuberculosis were retrospectively analyzed. Results The misdiagnosis rate of endobronchial tuberculosis was high, which was more common in young females. Lesions involved the left main bronchus, the upper lobes of the both lungs, and bronchofibroscopy showed 12 infiltrative infiltrates and 5 cases of necrotic lesions of granuloma 3 cases, 2 cases of stenosis of fibroids. Both mucosal biopsy and brush examination were performed. 16 cases were diagnosed by mucosal biopsy and 9 cases were confirmed by brushing bacteriology. Systemic anti-tuberculosis chemotherapy symptoms remission rate of 100%. Conclusion Fiberoptic bronchoscopy has important diagnostic value for tracheobronchial tuberculosis.