Goussard Pierre, Gie Robert
Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.
Paediatr Respir Rev. 2007 Jun;8(2):118-23. doi: 10.1016/j.prrv.2007.04.007. Epub 2007 Jun 7.
Lymph gland involvement of the airways is common in young children with pulmonary tuberculosis. This lymph gland involvement leads to lymphobronchial tuberculosis, which presents with varying degrees of airway obstruction. These children are best assessed by fibreoptic bronchoscopy and are treated with the normal anti-tuberculosis regimens to which corticosteroids are added for a month and then weaned off over the next month. If, after a month, the children remain symptomatic, they must be re-evaluated by bronchoscopy and chest computed tomography. Surgery must be considered in children with severe airway obstruction still present at the time of the second evaluation. Surgical intervention consists of endoscopic or transthoracic enucleation of the lymph nodes. Only a small percentage of those with lymphobronchial tuberculosis will require surgery to relieve their airway obstruction.
气道淋巴结受累在患有肺结核的幼儿中很常见。这种淋巴结受累会导致淋巴支气管结核，表现为不同程度的气道阻塞。对这些儿童进行评估的最佳方法是纤维支气管镜检查，并采用常规抗结核治疗方案，同时加用皮质类固醇治疗一个月，然后在下个月逐渐减量停药。如果一个月后儿童仍有症状，必须通过支气管镜检查和胸部计算机断层扫描进行重新评估。对于在第二次评估时仍存在严重气道阻塞的儿童，必须考虑手术治疗。手术干预包括内镜或经胸摘除淋巴结。只有一小部分淋巴支气管结核患者需要手术来缓解气道阻塞。
