论文部分内容阅读
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 investigate the value of CT and bronchoscope in the diagnosis of simple bronchial tuberculosis. Methods A retrospective analysis of 24 cases diagnosed as simple bronchial tuberculosis in patients with CT, bronchoscopy and pathological examination, sputum examination results before and after microscopic examination. Results CT examination found bronchial abnormalities in 19 cases (75%). There were 8 cases (33.3%) of the wall changes, including 5 cases of irregular and diffuse thickening, 3 cases of obvious thickening, 11 cases (41.7%) of lumen changes, including 10 cases of stenosis and 1 case of occlusion. Trachea, bronchial and hilar, mediastinal lymph nodes in 14 cases. Bronchoscopy abnormal changes in 24 cases. Inflammatory infiltration was observed mainly in 8 cases (33.3%), in 7 cases (29.2%), in granulation hyperplasia in 8 cases (33.3%) and in scar stenosis in 1 case (4.2 cases) %). 24 cases were mucosal biopsy and brush examination. Mucosal biopsy positive in 14 cases (58.3%), brushing positive in 11 cases (41.7%). Positive sputum examination before bronchoscopy in 5 cases (20.8%), sputum examination after mirror positive in 12 cases (50%). Conclusion CT examination can provide an important basis for the diagnosis of simple bronchial tuberculosis, help to understand the lesion location, shape, extent and extent and enlarged lymph nodes; bronchoscopy can be intuitive understanding of bronchial mucosal changes and classification, and through biopsy, brush Examination and sputum examination after microscopy can improve the diagnostic positive rate in the diagnosis of simple bronchial tuberculosis has an important value.