Keys Charles, McLeod Elizabeth, Pesti Christopher, Armstrong David
Department of Paediatric Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.
Eur J Pediatr Surg. 2012 Aug;22(4):315-7. doi: 10.1055/s-0032-1315802. Epub 2012 Jul 7.
Successful treatment of tuberculosis relies on microbiological diagnosis and drug sensitivities. Due to the pauci-bacillary nature of childhood infection, this is often not possible. We describe the successful microbiological diagnosis of tuberculosis using thoracoscopic pleural nodule biopsy.
In seven patients presenting with pulmonary tuberculosis and pleural involvement, but in whom microbiological diagnosis could not be established, thoracoscopic pleural biopsy was performed and analyzed for histology, acid-fast bacilli, polymerase chain reaction (PCR), DNA, culture, and drug sensitivities.
In five out of the seven patients we achieved positive histology, culture, and drug sensitivities. In the remaining two patients, histology, PCR, and DNA probe were positive for tuberculosis.
Thoracoscopic pleural biopsy is a sensitive aid to the diagnosis of pleural tuberculosis in children.
结核病的成功治疗依赖于微生物学诊断和药敏试验。由于儿童感染具有少菌性的特点，往往无法进行这些检查。我们描述了通过胸腔镜胸膜结节活检成功进行结核病微生物学诊断的病例。
7例患有肺结核并伴有胸膜受累但无法进行微生物学诊断的患者接受了胸腔镜胸膜活检，并对其进行组织学、抗酸杆菌、聚合酶链反应（PCR）、DNA、培养及药敏试验分析。
7例患者中有5例组织学、培养及药敏试验结果呈阳性。其余2例患者的组织学、PCR及DNA探针检测结果显示为结核阳性。
胸腔镜胸膜活检是诊断儿童胸膜结核的一种敏感辅助手段。
