洗胃和支气管肺泡灌洗在儿童肺结核细菌学诊断中的作用

Role of gastric lavage and broncho-alveolar lavage in the bacteriological diagnosis of childhood pulmonary tuberculosis.

作者信息

Singh M, Moosa N V, Kumar L, Sharma M

机构信息

Departments of Pediatrics and Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India.

出版信息

Indian Pediatr. 2000 Sep;37(9):947-51.

PMID:10992330

Abstract

OBJECTIVE

To compare the mycobacteriological yield from gastric lavage (GL) and bronchoalveolar lavage (BAL), in children with pulmonary tuberculosis.

METHODS

58 consecutive children with chest radiograph suggestive of tuberculosis and positive Mantoux test or a positive history of family contact with a case of tuberculosis were prospectively subjected to gastric lavage on three consecutive mornings and broncho-alveolar lavage on the last day. The samples were subjected to bacteriological isolation.

RESULTS

Samples from 10 (17.2%) children grew Mycobaterium tuberculosis from gastric lavage and 12 children had their BAL positive for this bacteria(p>0.05). Overall mycobacterial isolation was possible in 20 patients (34.4%) as two children had grown Mycobacterim tuberculosis in GL as well as BAL. Addition of BAL to the diagnostic work up increased the mycobacteriological yield from 17.2% with gastric lavage alone to 34.4% when BAL was also performed (p=0.013).

CONCLUSION

There is no difference in mycobacterial isolation rates from gastric lavage and BAL when studied in isolation. However, when both GL and BAL are used; these procedures complement each other to double the diagnostic yield.

摘要

目的

比较肺结核患儿胃灌洗（GL）和支气管肺泡灌洗（BAL）的分枝杆菌培养阳性率。

方法

对58例胸片提示肺结核且结核菌素试验阳性或有结核患者家庭接触史阳性的连续患儿，连续三个早晨进行胃灌洗，并在最后一天进行支气管肺泡灌洗。对样本进行细菌学分离。

结果

10例（17.2%）患儿的胃灌洗样本培养出结核分枝杆菌，12例患儿的支气管肺泡灌洗样本培养出该细菌（p>0.05）。20例患者（34.4%）总体上实现了分枝杆菌分离，因为有2例患儿的胃灌洗和支气管肺泡灌洗样本均培养出结核分枝杆菌。在诊断检查中增加支气管肺泡灌洗，分枝杆菌培养阳性率从单独胃灌洗时的17.2%提高到同时进行支气管肺泡灌洗时的34.4%（p=0.013）。