摘要
目的回顾性分析结核性肺毁损的临床特征和支气管镜镜下观的表现现象。方法回顾性总结和分析2000年1月～2010年12月经支气管镜检查的233例结核性肺毁损病例的临床特征和镜下观的表现现象。结果结核性肺毁损病例均为复治病例,病程长,平均(9.2±8.3)年,男性多于女性(161/72),年青女性(～30岁)病例明显多于年青男性(χ2=22.2>6.63,P<0.01),老年(～70岁,～80岁)男性病例明显多于老年女性(～70岁段:χ2=13.2>6.63,P<0.01,～80岁段:χ2=3.9>3.84,P<0.05),肺毁损所属支气管多患有支气管结核,易反复发生支气管感染和易再感染结核菌,支气管镜镜下观表现肺毁损所属支气管均扭曲、变形,导致管腔扩大、狭窄或闭塞,甚至恶变,或可见支气管空洞。支气管镜干预后,结核菌的检出率有明显提高(抗酸杆菌刷片阳性术前后比较χ2=16.8,P<0.01,结核杆菌培养阳性术前后比较χ2=5.8>3.84,P<0.05),但对普通细菌和真菌的检出率较低。结论结核性肺毁损与性别、年龄、支气管结核有一定的相关性,其并发症和后遗症严重,治疗难度较大。
【Objective】To explore the clinical characteristics and observe directly direct tuberculosis-destroyed lung （TDL） under bronchoscope.【Methods】The clinical characteristics and bronchoscopic direct observation of 233 cases TDL underwent bronchoscopy from January 2000 to December 2010 were retrospectively analyzed.【Results】 All TDL were the cases of retreatment and prolonged disease course, the average data is （9.2±8.3）years. The male was more than the female（161/72）, the young female （～30 years） was more than the young male （χ2 =22.26.63,P 0.01）, the elder male （～70 years, ～80years） was more than the elder female （～70 years： χ2 =13.26.63, P 0.01, ～80 years： χ2 =3.93.84, P 0.05）. Most bronchus belonged to TDL had bronchial tuberculosis, easy to repeat bronchial infection and easy to be affected with tuberculosis bacterium again, bronchoscopic direct observation showed all bronchial lumen belonged to TDL had more changes, bronchial distortion, and then led to bronchial lumen expand, stenosis and blocking, even to malignant transformation, or catch sight of bronchial cavity, after bronchoscopic intervene, detection rate of tuberculosis bacterium increased significantly （comparing brushing positive of acid-fast bacilli before with after operation： χ2 =16.8, P 0.01, comparing culture positive of mycobacterium tuberculosis before with after operation： χ2 =5.83.84, P 0.05）,but for ordinary bacteria and fungi detection rate was lower.【Conclusions】 TDL has a certain correlation with gender and age and endobronchial tuberculosis, its complication and sequelae is serious, and its therapy is difficult.
出处
《中国内镜杂志》
CSCD
北大核心
2013年第3期260-263,共4页
China Journal of Endoscopy
关键词
肺毁损
纤维支气管镜
检查结果
destroyed lung
fiberoptic bronchoscopy
bronchoscopic results
