Respiratory Diseases Department , Chinese PLA General Hospital, 28 Fuxing Rd, 100853 Beijing, China.
Eur J Clin Microbiol Infect Dis. 2011 Sep;30(9):1039-44. doi: 10.1007/s10096-011-1205-2. Epub 2011 Apr 16.
Endobronchial tuberculosis (EBTB), of which the incidence has been increasing in recent years, is a special type of pulmonary tuberculosis. The endobronchial tuberculose focuses often injure the tracheobronchial wall and lead to tracheobronchial stenosis. The tracheobronchial stenosis may cause intractable tuberculosis and make patients become chronic infection sources of tuberculosis, or may even cause pulmonary complications and result in death. The etiological confirmation of Mycobacterium tuberculosis is most substantial for diagnosis. However, because the positive rate of acid-fast bacillus staining for sputum smears is low and the clinical and radiological findings are usually nondistinctive, the diagnosis of EBTB is often mistaken and delayed. For early diagnosis, a high index of awareness of this disease is required and the bronchoscopy should be performed as soon as possible in suspected patients. The eradication of Mycobacterium tuberculosis and the prevention of tracheobronchial stenosis are two most substantial treatment goals. To get treatment goals, the diagnosis must be established early and aggressive treatments must be performed before the disease progresses too far.
支气管内膜结核(EBTB)近年来发病率不断增加,是一种特殊类型的肺结核。支气管内膜结核的病灶常累及气管支气管壁,导致气管支气管狭窄。气管支气管狭窄可引起难治性肺结核,使患者成为肺结核的慢性传染源,甚至可引起肺部并发症而导致死亡。结核分枝杆菌的病因学确证对诊断最为重要。然而,由于痰涂片抗酸杆菌染色的阳性率较低,且临床和影像学表现通常不具有特征性,因此 EBTB 的诊断常被误诊和延误。为了早期诊断,需要对该病有较高的认识意识,对疑似患者应尽快进行支气管镜检查。结核分枝杆菌的清除和预防气管支气管狭窄是两个最重要的治疗目标。为了实现治疗目标,必须尽早诊断,并在病情进一步发展之前进行积极治疗。