CAJ | 학술논문

目的探讨支气管镜下多种方法取材对痰菌阴性肺结核的诊断价值.方法回顾分析74例肺结核患者的临床资料,所有患者均行3次或以上痰抗酸染色,痰菌阳性者25例,痰菌阴性或无痰49例,其中28例行支气管镜活检、刷检涂片、支气管肺泡灌洗液(BALF)涂片及镜后痰检.结果 28例接受检查者镜下发现异常14例,占50.0％；病变处活检或经支气管镜肺活检(TBLB)病理符合典型结核表现15例,占53.6％；刷片抗酸染色阳性7例,占25.0％；BALF涂片阳性10例,占35.7％；镜后痰检阳性6例,占21.4％；多项指标联合,最终确诊23例,占82.1％.结论支气管镜检查下多种方法取材,对痰菌阴性肺结核诊断具有重要意义,有条件可尽早实施.
목적 탐토지기관경하다충방법취재대담균음성폐결핵적진단개치.방법 회고분석74례폐결핵환자적림상자료,소유환자균행3차혹이상담항산염색,담균양성자25례,담균음성혹무담49례,기중28례행지기관경활검、쇄검도편、지기관폐포관세액(BALF)도편급경후담검.결과 28례접수검사자경하발현이상14례,점50.0％；병변처활검혹경지기관경폐활검(TBLB)병리부합전형결핵표현15례,점53.6％；쇄편항산염색양성7례,점25.0％；BALF도편양성10례,점35.7％；경후담검양성6례,점21.4％；다항지표연합,최종학진23례,점82.1％.결론 지기관경검사하다충방법취재,대담균음성폐결핵진단구유중요의의,유조건가진조실시.
Objective To explore the diagnostic value of bronchoscopy combined materials drawn in multiply methods in patients with bacteriological negative pulmonary tuberculosis.Methods The clinical data of 74 patients with pulmonary tuberculosis were retrospectively analyzed.All the patients had sputum acid-fast staining more than three times,25 patients were sputum bacteriological positive and 49 patients were bacteriological negative or had no sputum.Bronchoscopy was performd in 28 cases,including biopsy examining,brush examining,bronchoalveolar lavage fluid(BALF) smear and sputum spear acid-fast stain test.Results In 28 patients undergoing examination,microscopic abnormalities were found in 14 cases,taken 50.0％.15 cases performed lesion biopsy or transbronchiallung biopsy(TBLB) were diagnosed tuberculosis,taken 53.6％.Brush acid-fast staining was positive in 7 cases,taken 25.0％.BALF smear postive in 10 cases,taken 35.7％.And phlegm test after bronchoscope positive in 6 cases,taken 21.4％.Combined multiply index,23 cases finally diagnosed as pulmonary tuberculosis,taken 82.1％.Conclusion Bronchoscopy with materials drawn in multiply methods has a high value in diagnosing bacteriological negative pulmonary tuberculosis,we should take advantage of it as soon as possible.