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目的探讨提高支气管结核患者临床诊断水平的方法。方法回顾性分析我院2004年至2009年收治的48例支气管结核患者的临床资料。结果所有患者均有咳嗽、咳痰病史;X线检查有2例考虑为结核病,确诊率为4.17%(2/48);有30例患者行CT检查,12例确诊,确诊率为40%(12/30);48例行纤维支气管镜检,32例确诊,确诊率为66.67%(32/48);常规痰抗酸染色涂片有12例发现结核杆菌,阳性率为25%(12/48),结合支气管镜取材39例抗酸染色涂片阳性,阳性率为81.25%(39/48);确诊率为81.25%(39/48);病理检查38例确诊,确诊率为79.17%(38/48)。结论 X线、胸部CT、PPD检查、常规痰涂片检查及纤维支气管镜检查对支气管结核的诊断都存在盲区,但纤维支气管镜镜检联合镜下取材行痰抗酸杆菌培养及涂片检查或者联合病理学检查能大大提高诊断水平。
Objective To explore ways to improve the clinical diagnosis of patients with bronchial tuberculosis. Methods The clinical data of 48 patients with bronchial tuberculosis admitted from 2004 to 2009 in our hospital were retrospectively analyzed. Results All patients had a history of cough and sputum. Two cases were considered as tuberculosis with X-ray examination and the diagnosis rate was 4.17% (2/48). Thirty patients had CT examination and 12 cases were diagnosed with a diagnosis rate of 40% 12 cases were diagnosed by fiberoptic bronchoscopy in 48 cases, the diagnosis rate was 66.67% (32/48) in 32 cases, and tuberculosis bacterium was found in 12 cases with conventional sputum acid-fast staining smear, the positive rate was 25% (12 / 48). The positive rate of the antibody was 81.25% (39/48) in 39 cases with bronchoscopy. The diagnosis rate was 81.25% (39/48). The pathological examination was confirmed in 38 cases, the diagnosis rate was 79.17% 38/48). Conclusion X-ray, chest CT, PPD examination, conventional sputum smear and fiberoptic bronchoscopy in the diagnosis of bronchial tuberculosis are blind, but bronchoscopy combined microscopy sputum acid bacilli sputum culture and smear examination or Combined pathological examination can greatly improve the diagnostic level.