摘要
目的探讨CT、支气管镜对单纯性支气管结核诊断价值。方法回顾性分析24例诊断为单纯性支气管结核患者的CT、支气管镜下表现及病理检查、镜检前后痰检结果。结果 CT检查共发现支气管异常改变19例(75%)。管壁改变8例(33.3%),其中不规则、弥漫性增厚5例,明显增厚3例;管腔改变11例(41.7%),其中狭窄10例,闭塞1例。气管、支气管周围及肺门、纵隔淋巴结肿大14例。支气管镜下异常改变24例。其中镜下肉眼观察炎症浸润型为主8例(33.3%),干酪坏死型为主7例(29.2%),肉芽增生型为主8例(33.3%),瘢痕狭窄型为主1例(4.2%)。24例均行粘膜活检及刷检。粘膜活检阳性14例(58.3%),刷检阳性11例(41.7%)。支气管镜检查前痰检阳性5例(20.8%),镜检后痰检阳性12例(50%)。结论 CT检查能够为单纯性支气管结核的诊断提供重要依据,有助于了解病变部位、形态、范围和程度及肿大淋巴结;支气管镜检查可直观了解支气管粘膜改变及分型,并通过活检、刷检及镜检后痰检可提高诊断的阳性率,在单纯性支气管结核诊断中有重要价值。
Objective To discuss the application of CT and bronchoscope in the diagnosis of simplex bronchial tube tuberculosis.Methods The imaging of chest CT and bronchoscope,pathology inspection,the result of phlegm examines were analyzed retrospectively in 24 cases with simplex bronchial tuberculosis.Results The CT inspection showed that 19 cases were with bronchial abnormality（75%）.8 cases（33.3%） were with bronchial wall changes,including 5 cases of irregularly and diffusely thickened wall and 3 cases of obviously thickened wall;11 cases（41.7%） were with lumen changes,including 10 cases of stenosis and 1 case of emphraxis.14 cases were with the lymph node tumescent in the lung hilus and mediastinum,or around the trachea and bronchus.24 cases were positive in the bronchoscopy,including 8 cases（33.3%） of inflammatory infiltration,7 cases（29.2%） of cheesy necrosis,8 cases（33.3%） of granulation hyperplasia,and 1 case（4.2%） of cicatricial constriction.All of 24 cases underwent the mucosa biopsy and brush biopsy,and the positive rate of the mucosa biopsy was 58.3%,and of the brush biopsy was 41.7%.The positive rate of the phlegm examines result was 20.8% before the bronchoscopy and 50% after the bronchoscopy.Conclusion CT inspection can provide the important basis for the diagnosis of simple bronchial tuberculosis,it is helpful in the understanding the location of lesion,shape,scope,degree and tumescent lymph node;The bronchoscope inspection may observe intuitively the bronchial mucous membrane changes and the types,with the mucosa biopsy,brush biopsy and phlegm examines,the diagnosis rate can be improved,so the bronchoscope has the important value in the diagnosis of simple bronchial tuberculosis.
出处
《中华全科医学》
2011年第12期1891-1892,共2页
Chinese Journal of General Practice
关键词
单纯性
支气管结核
CT
支气管镜
诊断
Simple
Bronchial tuberculosis
CT
Bronchoscope
Diagnosis
