Ip M S, So S Y, Lam W K, Mok C K
Chest. 1986 May;89(5):727-30. doi: 10.1378/chest.89.5.727.
Analysis was made of 20 patients with endobronchial tuberculosis proven by fiberoptic bronchoscopy and bronchial biopsy. Unlike prechemotherapy reports, the disease affects the older age group and more men. Only one half of the patients had fever, and the characteristic localized wheeze was found in 15 percent of cases. Chest roentgenogram showed typical collapse-consolidation in most cases; however, it was clear in 20 percent of patients. Sputum/smear was negative for AFB in 85 percent of patients. When the gelatinous granulation tissue was not found during bronchoscopy, a diagnosis of bronchogenic carcinoma was made incorrectly in 30 percent of patients. At a mean period of 27 months postchemotherapy, all 12 patients recalled for study developed bronchostenosis proven by bronchoscopy/bronchography except one. Noninvasive methods such as chest roentgenogram and flow-volume loops were insensitive for detection of stenosis. Steroid therapy probably did not influence outcome of tuberculous endobronchitis.
对20例经纤维支气管镜检查和支气管活检证实为支气管内膜结核的患者进行了分析。与化疗前的报告不同,该病影响年龄较大的人群,男性患者更多。只有一半的患者有发热,15%的病例发现有特征性的局限性哮鸣音。大多数病例胸部X线片显示典型的肺不张-实变;然而,20%的患者表现不明显。85%的患者痰涂片抗酸杆菌阴性。当支气管镜检查未发现胶冻状肉芽组织时,30%的患者被误诊为支气管源性癌。化疗后平均27个月时,除1例患者外,所有12例被召回进行研究的患者经支气管镜/支气管造影证实发生了支气管狭窄。胸部X线片和流量-容积环等非侵入性方法对狭窄的检测不敏感。类固醇治疗可能不会影响结核性支气管炎的预后。