de Gracia J, Curull V, Vidal R, Riba A, Orriols R, Martin N, Morell F
Seccion de Pneumologia, Hospital General Vall d'Hebron, Universidad Autonoma de Barcelona, Spain.
Chest. 1988 Feb;93(2):329-32. doi: 10.1378/chest.93.2.329.
Of 222 patients suspected of having pulmonary tuberculosis (PT), studied during a one-year period, we performed fiberoptic bronchoscopy together with bronchoalveolar lavage (BAL), bronchial washing and postbronchoscopy sputum smears and Löwenstein cultures in 20 patients. Bronchoalveolar lavage proved to be the most effective method leading to diagnosis in 17 of 20 cases. Diagnosis was obtained in 11 of 20 cases using bronchial washing and postbronchoscopy sputum. The results of this study suggest that bronchoscopy may be required in selected cases for the diagnosis of PT. However, it should be accompanied by BAL, bronchial washings and postbronchoscopy sputum smears. Indications for bronchoscopy as a diagnostic tool for PT may include: (a) patients suspected of having PT with negative smears and in whom treatment must be started due to clinical status; (b) suspicion of associated neoplasia; (c) selected patients with negative Löwenstein cultures; (d) lack of material being obtained by simpler methods.
在为期一年的研究中，对222例疑似肺结核（PT）的患者进行了检查，我们对其中20例患者进行了纤维支气管镜检查，同时进行了支气管肺泡灌洗（BAL）、支气管冲洗以及支气管镜检查后的痰涂片和罗氏培养。支气管肺泡灌洗被证明是最有效的方法，在20例中有17例通过该方法得以确诊。通过支气管冲洗和支气管镜检查后的痰液，20例中有11例得到确诊。本研究结果表明，在某些特定病例中诊断PT可能需要进行支气管镜检查。然而，应同时进行支气管肺泡灌洗、支气管冲洗以及支气管镜检查后的痰涂片。支气管镜作为PT诊断工具的适应证可能包括：（a）涂片阴性但因临床状况必须开始治疗的疑似PT患者；（b）怀疑合并肿瘤；（c）罗氏培养阴性的特定患者；（d）通过更简单方法无法获取样本。
