摘要
目的 探讨儿童支气管结核 (EBTB)的纤维支气管镜 (纤支镜 )诊断及分型。方法 回顾性总结、分析临床治疗不顺利的肺结核或可疑肺结核的住院患儿 110例 ,均经纤支镜诊查 ,归纳EBTB病变在纤支镜下表现 ,并分型为 :粘膜型、干酪型、管腔型和混合型。 110例均摄胸部X线片 (其中做胸部CT检查 6 2例 ) ,追踪临床诊疗过程和最终诊断 ,以验证纤支镜诊断。再评估纤支镜在儿童EBTB诊查中的作用 ,提出EBTB诊断标准。结果 纤支镜诊断 10 8例EBTB ,其中混合型 78例、粘膜型 18例、管腔型 9例、干酪型 3例。临床合并各型儿童肺结核 91例。在纤支镜确诊的 17例EBTB中 ,胸部X线片均未提供特异性结核证据 ,气道分泌物结核菌阳性 15例。本文结核菌阳性率为 5 3%。结论 儿童EBTB并非少见 ,其诊断在临床有重要意义 ;儿童EBTB可以原发 ;本文试行的儿童EBTB分型方法简便易行。纤支镜是诊断EBTB的必需工具。
Objective To explore the diagnostic criteria of endobronchial tuberculosis(EBTB) in children under flexible bronchoscopy(FBSP).Methods A hundred and ten cases with tuberculous pneumonia were performed FBSP examination and studied prospectively between 1992～2002 in Beijing Children's Hospital.The features of EBTB in children under FBSP were summarized and divided into four groups:indomucous membrane,caseating,bronchial lumen and blending.Chest radiographes were taken in all the patients and CT in 62 of them.All patients were followed up and the role of FBSP in children EBTB was re assessed.The diagnostic criteria of EBTB was discussed.Results EBTB occured in 108,of which blending type were in 78,indomucous membrane in 18,bronchial lumen in 9 and caseating in 3.91 were diagnosed as PTB(pulmonary tuberculosis) clinically,and 33 were tubercle bacili positive,17 were found as EBTB by FBSP and tubercle bacili positive in 15 There were primary PTB in children PTB and blend in EBTB mainly.Conclusion EBTB isn't rare in children.Most PTB are accompanied by EBTB,some of EBTB may occur alone in children.The above mentioned classification of EBTB is feasible and simple in children.FBSP is indispensable for the diagnosis of EBTB.
出处
《中国实用儿科杂志》
CSCD
北大核心
2003年第9期534-536,T001,共4页
Chinese Journal of Practical Pediatrics
关键词
支气管结核
纤维支气管镜
诊断
儿童
分型
Children Endobronchial tuberculosis classification Flexible bronchoscopy
