关键词: 结核,支气管, CT, 支气管镜检查

Abstract: Objective To find out the clinical features of endobronchial tuberculosis and approaches to its early diagnosis.Methods Clinical symptoms,chest X-ray/CT scans and fiberoptic bronchoscopic (FB) findings of 69 cases with endobronchial tuberculosis were analyzed.Results Main symptoms were as follows:68 had cough,44 had expectoration with sputum,50 had light fever after noon,49 had night sweat,48 had asthenia,18 had breathlessness,13 had blood-stained sputum.Chest X-ray and CT demonstrated:42 cases showed uneveness and irregular narrowing of the inner bronchial wall,26 cases showed obstructive pneumonia,25 cases showed atelectasis,14 cases showed pulmonary cavity,11 cases showed hilar lymphadenovarix.Positive sputum smear and culture for acid-fast bacilli (AFB) were 43.5% and 36.2%,respectively.Staining for AFB was 55.1% positive in bronchial washings and diagnosis was confirmed by bronchoscopic biopsy specimens in 56.7%.Bronchoscopic Results showed exduative lesions in 40.6% of the cases,granulomatous in 13.0%,ulcerative lesions in 29.0% and cicatricial lesions in 26.1%.Positive ratio of found AFB for the four subtypes were 71.4%,77.8%,100% and 55.6%,respectively.Conclusion We should select patients by chest X-ray when they have clinical manifestation as described above and CT were examed for the observed lesions.Bronchoscopic was done when the patients were suspected.When endobronchial tuberculosis couldn’t be confirmed by pathology and bacteriology,the follow-up bronchoscopic biopsy,brushing examination and anti-tuberculosis treatment should be repeatedly preformed until the diagnosis was confirmed by the follow observation.

Key words: Tuberculosis,endobronchial, CT, Bronchoscopy