【摘要】 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。

    【关键词】 支气管镜检查;支气管结核;诊断

    【Abstract】 Objective Investigate the using of the fiberoptic bronchoscopy in the diagnosis of bronchial tuberculosis. Methods Retrospective analysis the clinical manifestations, diagnosis and treatment of 22 cases of bronchial tuberculosis in patients with normal chest X-ray. Results The rate of misdiagnosis of endobronchial tuberculosis is high.The endobronchial tuberculosis is more common in young women,and involves the left main bronchialand two upper lungs in main.12 cases of the patients were infiltrating inflammatory lesions by fiberoptic bronchoscopy, five cases were cheese necrotizing granulomatous lesions,3 cases were proliferative lesion,and 2 cases were fiber-type lesion stenosis.All of the cases underwent mucosal biopsy and brush biopsy.And 16 cases were confirmed by mucosal biopsy;9 cases were confirmed by brushing bacteriology; 22 cases wereco-diagnosed of the two.The remission rate of the systemic anti-TB chemotherapy was 100%. Conclusion The fiberoptic bronchoscopy has important diagnostic value for tracheobronchial tuberculosis. ......