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目的探讨纤维支气管镜(纤支镜)检查对菌阴肺结核的诊断意义。方法对菌阴肺结核患者123例纤支镜检查结果进行回顾性分析,了解镜下表现及组织活检病理、支气管刷检涂片和术后痰找抗酸杆菌对肺结核的诊断阳性率。结果本组病例中纤支镜下主要表现为管口或管腔瘢痕狭窄26.0%(32/123),黏膜表面有白色苔状物或豆腐渣样物覆盖21.2%(26/123),黏膜充血肿胀17.9%(22/123),肉芽肿样新生物17.1%(21/123),多发结节样新生物8.1%(10/123)。组织活检病理、支气管刷片以及术后痰涂片找抗酸杆菌检查,诊断肺结核的阳性率分别为75.5%(77/102),45.5%(56/123),38.2%(26/68),联合取材诊断率达100%。结论纤支镜检查是临床诊断菌阴肺结核的又一重要途径,组织活检病理、支气管刷片以及术后痰菌检查相互补充,可提高确诊率,减少误诊。
Objective To investigate the diagnostic value of bronchoscopy (bronchofibroscopy) for diagnosis of tuberculosis of bacteria and yin. Methods A retrospective analysis was performed on the results of 123 bronchoscopy tests in patients with bacterial and pulmonary tuberculosis to find out the positive diagnostic rates of pulmonary tuberculosis by microscopic examination, histopathology, bronchial brush smears and postoperative sputum. Results In this group of patients, bronchofibroscopy mainly showed 26.0% (32/123) stenosis of the orifice or lumen and 21.2% (26/123) of the mucosal surface covered with white moss or bean curd residue. Mucosal hyperemia 17.9% (22/123) swollen, 17.1% (21/123) of newly diagnosed granulomatous neoplasms, and 8.1% (10/123) of frequently occurring nodular neoplasms. The positive rate of diagnosis of tuberculosis was 75.5% (77/102), 45.5% (56/123), 38.2% (26/68), respectively. The positive rate of tuberculosis in tissue biopsy, bronchial brushing and postoperative sputum smear, The combined diagnosis rate of 100%. Conclusions Fiberoptic bronchoscopy is another important way to clinically diagnose negative pulmonary tuberculosis. The combination of biopsy pathology, bronchial brushing and postoperative sputum examination can improve the diagnosis rate and reduce the misdiagnosis.