Chan S, Abadco D L, Steiner P
Department of Pediatrics, State University of New York, Health Sciences Center at Brooklyn 11203.
Pediatr Infect Dis J. 1994 Jun;13(6):506-9. doi: 10.1097/00006454-199406000-00008.
Flexible fiberoptic bronchoscopy (FB) is a recently available tool for the investigation of pediatric pulmonary diseases. Endobronchial tuberculosis (ETB), a common complication of primary tuberculosis, has traditionally been diagnosed by clinical findings of bronchial obstruction and roentgenographic evidence of bronchial involvement. A retrospective study was conducted to determine the incidence of endobronchial tuberculosis in children diagnosed by traditional means as having uncomplicated primary tuberculosis. Analysis of the bronchoscopic findings of 36 children with active pulmonary tuberculosis revealed that 15 (41.7%) had endobronchial involvement. Significantly 10 (28%) children who had no clinical or radiologic evidence of endobronchial involvement had endobronchial tuberculosis; 4 (11%) had early and 6 (17%) had advanced ETB by FB. There were 6 patients with radiologic evidence suggestive of ETB, which was confirmed by FB in 5 patients. One child had a obstruction of a bronchus by mucus. The mucus was removed with subsequent expansion of the distal lung segment. Complications of the procedures were mild. FB is a safe procedure and a valuable aid for the rapid diagnosis of ETB.
可弯曲纤维支气管镜检查（FB）是近年来用于小儿肺部疾病检查的一种工具。支气管内膜结核（ETB）是原发性肺结核的常见并发症，传统上通过支气管阻塞的临床表现及支气管受累的影像学证据来诊断。进行了一项回顾性研究，以确定通过传统方法诊断为无并发症原发性肺结核的儿童中支气管内膜结核的发病率。对36例活动性肺结核患儿的支气管镜检查结果分析显示，15例（41.7%）有支气管内膜受累。值得注意的是，10例（28%）无支气管内膜受累临床或影像学证据的患儿存在支气管内膜结核；4例（11%）为早期ETB，6例（17%）为进展期ETB。有6例患儿有提示ETB的影像学证据，其中5例经FB证实。1例患儿支气管被黏液阻塞，清除黏液后远端肺段扩张。检查过程中的并发症较轻。FB是一种安全的检查方法，对ETB的快速诊断有重要帮助。
