Pant K, Chawla R, Mann P S, Jaggi O P
Clinical Research Centre, Vallabhbhai Patel Chest Institute, University of Delhi, India.
Chest. 1989 May;95(5):1151-2. doi: 10.1378/chest.95.5.1151.
Twenty-two patients with smear-negative miliary tuberculosis underwent fiberbronchoscopy and brush smears; bronchial aspirates and transbronchial lung biopsy specimens were obtained. A definite diagnosis of tuberculosis was made in 16 (73 percent) patients. A rapid diagnosis was established in 14 of these 16 patients either from brush smears alone (three) or bronchial aspirate smear alone (one) or exclusively by histopathologic study of biopsy specimens (seven). Both brush smears and biopsy histopathology results provided the diagnosis in three patients. Bronchial aspirate culture was the only positive specimen in two patients. No serious complication resulted from the procedure. Our experience substantiates previous reports of the value and safety of fiberbronchoscopy in the rapid diagnosis of smear-negative miliary tuberculosis.
22例涂片阴性粟粒型肺结核患者接受了纤维支气管镜检查及刷检涂片；获取了支气管吸出物及经支气管肺活检标本。16例（73%）患者确诊为肺结核。这16例患者中有14例通过单独刷检涂片（3例）、单独支气管吸出物涂片（1例）或仅通过活检标本的组织病理学检查（7例）得以快速确诊。刷检涂片及活检组织病理学结果均为3例患者提供了诊断依据。支气管吸出物培养是2例患者唯一的阳性标本。该操作未导致严重并发症。我们的经验证实了先前关于纤维支气管镜检查在涂片阴性粟粒型肺结核快速诊断中的价值及安全性的报道。
