支气管结核病患者临床表现特征与诊治分析
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四川省科技计划支撑项目(2013SZ0001)


Clinical features,diagnosis and treatment of patients with bronchial tuberculosis
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    摘要:

    【摘要】 目的 探讨支气管结核的临床表现特征和诊治方法及治疗效果。方法 分析经临床病理诊断的62例支气管结核患者的临床表现特征、诊断方法及不同治疗方法的临床效果。结果 62例支气管结核患病中女性多于男性(P<005),3045岁的青中年是高发人群,临床表现主要包括咳嗽、咳血等症状,从患者发病到确诊为支气管结核所需时间较长。62例患者中,X线胸片确诊率为16%(10/62),支气管镜发现率为100%(62/62),活检阳性率为63%(39/62),刷片阳性率为24%(15/62),支气管镜检查总阳性率为87%(54/62),痰涂片阳性率为21%(13/62),总菌阳性率达到35%(22/62),活检、刷片和痰涂片总阳性率为90%(56/62)。随访42例中治愈率74%(31/42),好转率24%(10/42),3个月后痰菌转阴率为100%(42/42),未见复发病例。结论 支气管结核患者无特异性相关临床表现,临床误诊和漏诊率均较高。支气管镜检查能提高支气管结核诊断率,减少误诊、漏诊,有利于提高患者疗效,可在临床推广应用。

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    【Abstract】 Objective To investigate the clinical features, diagnosis and treatment of bronchial tuberculosis. Methods The clinical features, diagnostic methods and clinical results of different treatment methods in 62 patients of bronchial tuberculosis were analyzed. Results The bronchial tuberculosis prevalence rate of female was higher than that of male(P<0.05). The middleaged in 3045 years old was a high risk population. The main clinical manifestations included chronic cough, expectoration and hemoptysis. The chest Xray diagnosis rate was 16% (10/62). The chest CT diagnosis rate was 21% (13/62). The bronchoscope was 100%. The positive rate of biopsy was 63% (39/62). The brush positive rate was 24% (15/62). The total positive rate of bronchoscopy was 87% (54/62). The sputum smear positive rate was 21% (13/62). The total bacteria positive rate was 35% (22/62). The biopsy, brushing and sputum smear positive rate was 90% (56/62). The total effective rate was 100% (42/42). The cure rate was 74% (31/42). The improvement rate was 24% (10/42). The sputum negative conversion rate was 100% (42/42).Conclusion The clinical manifestation of patients with bronchial is lack of specificity. The missed diagnosis and misdiagnosis rate is high. Bronchoscopy is an ideal method for clinical diagnosis of bronchial tuberculosis. Early diagnosis and comprehensive treatment can improve curative effect and reduce the incidence of lung injury and other complications.

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  • 在线发布日期: 2017-08-03
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