Lee Pyng
Associate Professor, National University of Singapore, Singapore; Director of Interventional Pulmonology, Senior Consultant, Division of Respiratory and Critical Care Medicine, National University Hospital, 1E Kent Ridge Road 119228, Singapore.
Indian J Tuberc. 2015 Jan;62(1):7-12. doi: 10.1016/j.ijtb.2015.02.002. Epub 2015 Mar 18.
Endobronchial tuberculosis refers to tuberculous infection of the tracheobronchial tree. Diagnosis requires a high index of suspicion since symptoms are attributed to co-existing pulmonary tuberculosis and airway lesions are not detectable on chest radiograph. While computed tomography and bronchoscopy are useful for the evaluation of tracheobronchial stenosis or obstruction, goals of treatment remain in the eradication of tubercle bacilli and prevention of airway stenosis. Corticosteroids may halt progression of active disease to fibro-stenotic stage, however if tracheobronchial stenosis causing post-obstructive pneumonia, atelectasis and dyspnea has occurred, airway patency must be restored mechanically by surgery or bronchoscopic techniques.
支气管内膜结核是指气管支气管树的结核感染。由于症状常归因于合并存在的肺结核,且胸部X线片无法检测到气道病变,因此诊断需要高度的怀疑指数。虽然计算机断层扫描和支气管镜检查有助于评估气管支气管狭窄或阻塞,但治疗目标仍然是根除结核杆菌并预防气道狭窄。皮质类固醇可能会阻止活动性疾病进展到纤维狭窄阶段,然而,如果已经发生导致阻塞性肺炎、肺不张和呼吸困难的气管支气管狭窄,则必须通过手术或支气管镜技术机械地恢复气道通畅。