Liu F, Rao X C, Ma Y Y, Meng C F, Pan Y N, Liu H, Shen A D, Jiao Anxia
Department of Interventional Pulmonology, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health(NCCH), Beijing 100045, China.
Imaging Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health(NCCH), Beijing 100045, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2022 Mar 12;45(3):282-288. doi: 10.3760/cma.j.cn112147-20210624-00444.
To provide theoretical basis for early diagnosis and accurate bronchoscopic classification of tracheobronchial tuberculosis (TBTB) in children through analyzing the clinical characteristics, bronchoscopic classifications and treatment effect in children with TBTB. In this respective study, we collected clinical data of patients with TBTB who accepted bronchoscopies in Interventional Pulmonology Department of Beijing Children's Hospital Affiliated to Capital Medical University between January, 2006 and December, 2019. The basic data, including clinical manifestations, imaging features, bronchoscopic characteristics and effects of interventional therapy were analyzed. The results of the study were statistically described and analyzed using SPSS 22.0 statistical software for relevant data. Total 252 children with TBTB were included in this study. The median age was 1.7 years (quartile: 0.8 years, 5.2 years). Analysis of the classification of TBTB showed that the percent of lymph node fistula type was 96.4% (243/252), ulcerative necrosis type 1.2%(3/252), granulation proliferation type 0.4% (1/252), and cicatricial stricture type 0.8% (2/252). In addition, 1.2% (3/252) of the cases showed the same bronchoscopic manifestations as lymph node fistula type, but it was not clear on imaging whether the caseous material in the lumen was caused by lymph node or lung erosion. Therefore, the "bronchial fistula type" was proposed. Lymph node fistula type of TBTB was the common in children. The classification of lymph node fistula mostly depended on imaging evidence, and this may lead to some uncertainty in classifying TBTB in cases with no imaging evidence of enlarged lymph nodes.
通过分析儿童气管支气管结核（TBTB）的临床特征、支气管镜分类及治疗效果，为儿童TBTB的早期诊断及准确的支气管镜分类提供理论依据。在这项单中心研究中，我们收集了2006年1月至2019年12月在首都医科大学附属北京儿童医院介入肺科接受支气管镜检查的TBTB患者的临床资料。分析了包括临床表现、影像学特征、支气管镜特征及介入治疗效果等基础数据。使用SPSS 22.0统计软件对相关数据进行统计描述和分析。本研究共纳入252例儿童TBTB患者。中位年龄为1.7岁（四分位数：0.8岁，5.2岁）。TBTB分类分析显示，淋巴结瘘型占96.4%（243/252），溃疡坏死型占1.2%（3/252），肉芽增生型占0.4%（1/252），瘢痕狭窄型占0.8%（2/252）。此外，1.2%（3/252）的病例支气管镜表现与淋巴结瘘型相同，但影像学上不清楚管腔内干酪样物质是由淋巴结还是肺浸润引起。因此，提出“支气管瘘型”。儿童TBTB以淋巴结瘘型最为常见。淋巴结瘘型的分类主要依赖影像学证据，对于无肿大淋巴结影像学证据的TBTB病例，这可能导致分类存在一定不确定性。
