Watanabe K, Inoue Y, Shimoda T, Watanabe T, Hayashi T, Tsutsumi T, Dotsu Y, Kohno S, Yamaguchi K, Hara K
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Kekkaku. 1990 Mar;65(3):227-30.
Fiberoptic bronchoscopy is a well established methods as a useful tool in the diagnosis of pulmonary tuberculosis with smear negative cases. In order to get the early and definite diagnosis of pulmonary tuberculosis, we performed transbronchial aspiration and bronchial lavage by a fiberoptic bronchoscope in 97 patients. All patients (1) were clinically suspected of having active tuberculosis; (2) showed abnormal chest roentgenogram suggesting tuberculosis; (3) showed negative sputum smears of acid-fast bacilli, or had no sputum. The results of the study were summarized as follows: 1) Final diagnosis of study subjects were 90 patients of active pulmonary tuberculosis, and 7 patients of pulmonary atypical mycobacteriosis. 2) Sputum culture of acid-fast bacilli was positive in 22 out of 90 patients with active pulmonary tuberculosis. 3) Smear and culture examination of acid-fast bacilli of transbronchial aspirates were positive in 9 and 28, respectively out of 90 patients. 4) Smear and culture examination of acid-fast bacilli of bronchial lavage were positive in 12 and 39, respectively out of 90 patients. 5) A rapid and definite diagnosis was made in 16 out of 90 patients by transbronchial aspirates or bronchial lavage. 6) Atypical mycobacteria were detected in 7 out of 97 patients by transbronchial aspirates or bronchial lavage. 7) There were no serious complications such as pneumonia and exacerbation of pulmonary tuberculosis. These results suggested that transbronchial aspiration and bronchial lavage were useful procedures for rapid and definite diagnosis of pulmonary tuberculosis.
纤维支气管镜检查是一种成熟的方法，是诊断涂片阴性肺结核病例的有用工具。为了早期明确诊断肺结核，我们对97例患者进行了纤维支气管镜下经支气管吸引和支气管灌洗。所有患者：（1）临床上怀疑患有活动性肺结核；（2）胸部X线片显示异常提示肺结核；（3）痰涂片抗酸杆菌阴性或无痰。研究结果总结如下：1）研究对象的最终诊断为90例活动性肺结核患者和7例肺部非典型分枝杆菌病患者。2）90例活动性肺结核患者中，22例痰抗酸杆菌培养阳性。3）90例患者中，经支气管吸引物抗酸杆菌涂片和培养检查分别有9例和28例阳性。4）90例患者中，支气管灌洗抗酸杆菌涂片和培养检查分别有12例和39例阳性。5）90例患者中，16例通过经支气管吸引或支气管灌洗获得了快速明确的诊断。6）97例患者中，7例通过经支气管吸引或支气管灌洗检测出非典型分枝杆菌。7）未出现诸如肺炎和肺结核病情加重等严重并发症。这些结果表明，经支气管吸引和支气管灌洗是快速明确诊断肺结核的有用方法。
