Chan H S, Sun A J, Hoheisel G B
Department of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin.
Lung. 1990;168(4):215-20. doi: 10.1007/BF02719695.
The ability to make a definitive diagnosis in sputum smear-negative pulmonary tuberculosis by bronchoscopic aspiration, bronchoalveolar lavage (BAL), and examination of postbronchoscopy sputum were compared. Thirty-four patients with lesions on chest x-rays suspected of being pulmonary tuberculosis were entered into the study. The diagnosis of pulmonary tuberculosis was subsequently confirmed in 28 patients and the method of arriving at the final diagnosis was analyzed. A positive acid-fast bacilli (AFB) smear result was obtained in 4/28 (14%) of cases by a combination of bronchoscopic techniques and postbronchoscopy sputum examination. Prebronchoscopy sputum culture was positive in 12/28 (43%). Combined with bronchoscopy specimens, a positive AFB culture result was obtained in 26/28 (93%). Sputum examination, bronchoscopic aspiration, and BAL are complementary techniques and together they give a high yield of definitive diagnosis of pulmonary tuberculosis.
对通过支气管镜抽吸、支气管肺泡灌洗（BAL）以及支气管镜检查后痰液检查来明确诊断痰涂片阴性肺结核的能力进行了比较。34例胸部X线有疑似肺结核病变的患者纳入研究。随后28例患者确诊为肺结核，并对最终确诊方法进行了分析。通过支气管镜技术和支气管镜检查后痰液检查相结合，4/28（14%）的病例获得了抗酸杆菌（AFB）涂片阳性结果。支气管镜检查前痰培养12/28（43%）为阳性。结合支气管镜标本，26/28（93%）获得了AFB培养阳性结果。痰液检查、支气管镜抽吸和BAL是互补技术，它们共同为肺结核的明确诊断提供了高检出率。
