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中国防痨杂志 ›› 2022, Vol. 44 ›› Issue (4): 322-328.doi: 10.19982/j.issn.1000-6621.20210722

• 论著 • 上一篇    下一篇

镜下非活动期中心型气管支气管结核的临床表现及影像学特征分析

郭洋1, 秦林1, 徐慧芳1, 赵营1, 王文洁1, 付文侠1, 王国春1, 啜峻玮1, 丁卫民1(), 傅瑜2   

  1. 1首都医科大学附属北京胸科医院内镜诊疗科,北京 101149
    2中国疾病预防控制中心结核病防治临床中心,北京 101149
  • 收稿日期:2021-12-27 出版日期:2022-04-10 发布日期:2022-04-06
  • 通信作者: 丁卫民 E-mail:dwm6606@163.com
  • 基金资助:
    北京市临床重点专科项目(20201214)

Analysis of clinical manifestations and imaging features of inactive central tracheobronchial tuberculosis using microscope

GUO Yang1, QIN Lin1, XU Hui-fang1, ZHAO Ying1, WANG Wen-jie1, FU Wen-xia1, WANG Guo-chun1, CHUAI Jun-wei1, DING Wei-min1(), FU Yu2   

  1. 1Department of Endoscopic Diagnosis and Treatment, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China
    2Clinical Center on Tuberculosis, Chinese Center for Disease Control and Prevention, Beijing 101149, China
  • Received:2021-12-27 Online:2022-04-10 Published:2022-04-06
  • Contact: DING Wei-min E-mail:dwm6606@163.com
  • Supported by:
    Beijing Key Clinical Specialty Project(20201214)

摘要:

目的: 探讨不同类型镜下非活动期中心型气管支气管结核(简称“气管支气管结核”)的特征。 方法: 回顾性分析2017年1月至2020年12月首都医科大学附属北京胸科医院收治的267例镜下非活动期气管支气管结核患者的临床表现、影像学特征及支气管镜下检查情况。 结果: 267例患者中,男性79例,女性188例,男女比例为1∶2.38;年龄以20~40岁年龄组为主(55.43%,148/267)。临床表现:胸闷、气促 221 例(82.77%),咳嗽、咳痰166例(62.17%),发热35例(13.11%),咯血15例(5.62%),无症状20例(7.49%)。非活动期气管支气管结核主要累及部位:左主支气管124例(46.44%),右中间段支气管69例(25.84%),右主支气管48例(17.98%),气管26例(9.74%);左侧∶右侧病变比为1∶0.94(124∶117)。267例患者中,以管壁软化型为主者21例(7.87%),以瘢痕狭窄型为主者198例(74.16%),以管腔闭塞型为主者15例(5.62%),以反复回缩型为主者33例(12.36%);合并肺不张169例(63.30%),并发肺内空洞116例(43.45%),出现肺内多病灶195例(73.03%)。支气管管腔狭窄的CT表现与支气管镜检查检出符合率为98.13%(262/267)。 结论: 镜下非活动期气管支气管结核以女性、中青年人群多见,最常见症状为胸闷、气促,咳嗽、咳痰;CT检查与支气管镜检查检出符合率高,是镜检前的重要诊断手段。

关键词: 结核, 支气管镜检查, 疾病特征, 体层摄影术,X线计算机

Abstract:

Objective: To investigate the features of inactive central tracheobronchial tuberculosis (tracheobronchial tuberculosis) using different types of microscopes. Methods: The clinical manifestations, imaging features, and bronchoscopic findings of 267 tracheobronchial tuberculosis patients admitted to Beijing Chest Hospital from January 2017 to December 2020 were retrospectively analyzed. Results: Of the 267 cases, 79 were male and 188 were female, the ratio of male to female was 1∶2.38; and the patients were mainly 20-40 years old (55.43%, 148/267). Common symptoms were dyspnea (221 cases, 82.77%), cough and sputum (166 cases, 62.17%), fever (35 cases, 13.11%), hemoptysis (15 cases, 5.62%), and non-symptoms (20 cases, 7.49%). The main involved parts of inactive tracheobronchial tuberculosis were left principal bronchus (124 cases, 46.44%), right intermediate bronchus (69 cases, 25.84%), right principal bronchus (48 cases, 17.98%), trachea (26 cases, 9.74%), the ratio of left to right was 1∶0.94 (124∶117). Among the total 267 cases, 21 were soft type (7.87%), 198 were stenotic type (74.16%), 15 were occlusion type (5.62%), 33 were frequent retraction type (12.36%); 169 complicated with atelectasis (63.30%), 116 complicated with pulmonary cavitation (43.45%), and pulmonary multiple niduses was found in 195 cases (73.03%). The coincidence rate of bronchial luminal stenosis between CT scan and bronchoscope was 98.13% (262/267). Conclusion: Inactive tracheobronchial tuberculosis is common in women, middle-aged and young people. The most common symptoms are dyspnea, cough and sputum. The coincidence rate of CT scan is high, and CT scan is an important diagnostic method before bronchoscopy.

Key words: Tuberculosis, Bronchoscopy, Disease attributes, Tomography,X-ray computed

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