呼吸系统疾病专栏

纤维支气管镜在支气管内膜结核病诊断中的价值

  • 陈艳萍 ,
  • 黄建宝 ,
  • 李秀龙 ,
  • 孟燕妮
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  • 湖南省儿童医院呼吸二科 ( 湖南长沙 410007)

收稿日期: 2014-08-15

  网络出版日期: 2014-08-15

Diagnostic value of fiberobronchoscopy in endobronchial tuberculosis

  • CHEN Yanping ,
  • HUANG Jianbao ,
  • LI Xiulong ,
  • MENG Yanni
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  • Department of Respiratory, Hunan Children's Hospital, Changsha 410007, Hunan, China

Received date: 2014-08-15

  Online published: 2014-08-15

摘要

目的 评价纤维支气管镜对支气管内膜结核病的诊断价值。方法 2010年3月至2012年12月疑诊支气管内膜结核住院患儿67例,均行胸部CT及纤维支气管镜检,支气管肺泡灌洗液(BALF)作结核杆菌培养、荧光定量PCR、夹层杯法和病理活检。结果 经检查临床确诊支气管内膜结核50例,支气管内膜结核镜下病变部位广泛、形态多样化。支气管内膜结核患儿的BALF FQ-PCR检测阳性率为60%,夹层杯法阳性率42%,灌洗液结核菌培养阳性率20%;病理活检阳性率46%;BALF FQ-PCR联合夹层杯法检测,阳性率可提高至76%(38/50),明显高于灌洗液结核菌培养和病理活检阳性率。结论 纤维支气管镜检查为诊断支气管内膜结核的有效手段。

本文引用格式

陈艳萍 , 黄建宝 , 李秀龙 , 孟燕妮 . 纤维支气管镜在支气管内膜结核病诊断中的价值[J]. 临床儿科杂志, 2014 , 32(8) : 709 . DOI: 10.3969 j.issn.1000-3606.2014.08.003

Abstract

Objective To assess the value of fiberobronchoscopy in the diagnosis of endobronchial tuberculosis. Methods A total of 67 children suspected of endobronchial tuberculosis in our ward from March 2010 to December 2012 had been tested by chest CT and fiberobronchoscopy, mycobacteria culture, liquid-based interlayer vessel technique and FQ-PCR from bronchoalveolar lavage fluid and biopsy. Results 50 patients were clinically diagnosed as endobronchial tuberculosis. The positive rate of FQ-PCR (60%) and liquid-based interlayer vessel technique (42%) are higher than that of mycobacteria culture (20%), which showed no significant difference with biopsy. The positive rate of the combined detection (FQ-PCR and liquid-based interlayer vessel technique) is significantly higher than that of mycobacteria culture and biopsy. Conclusions Fiberobronchoscopy is effective for the diagnosis of endobronchial tuberculosis.
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