纤维支气管镜检查对无痰或痰菌阴性不典型肺结核的诊断价值

目的 探讨纤维支气管镜（简称“纤支镜”）检查对无痰或痰菌阴性不典型肺结核的诊断价值。 方法 选无痰或痰菌阴性的不典型肺结核患者201例，用纤支镜在病变部位进行活检、刷检、支气管肺泡灌洗液（BALF）进行BBLMGIT(Mycobacteria Growth Indicate Tube)分枝杆菌快速培养查结核杆菌。术后进行痰涂片查抗酸杆菌、痰结核分枝杆菌快速培养。 结果201例刷检、BALF快速培养结核分枝杆菌阳性率分别是67.2%、83.6%，61例活检阳性率63.9%，201例术后痰涂片、术后痰快速培养结核分枝杆菌阳性率分别是28.9%、57.2%。 结论 纤支镜检查是确诊无痰或痰菌阴性不典型肺结核的有效方法 ，其中BALF行结核分枝杆菌快速培养具有较高的诊断价值、快速、阳性率较高。根据镜下所见采用不同的取材方法 可望提高诊断率。

Diagnostic value of fiberoptic bronchoscopy in atypical pulmonary tuberculosis with no sputum or negative sputum smear

Objective To study the diagnostic value of fiberoptic bronchoscopy in atypical pulmonary tuberculosis with no sputum or negative sputum smear.Methods Bronchial brushing,and rapid culture for Mycobacterium tuberculosis in bronchoalveolar fluid(BALF)were performed for 201 cases with atypical pulmonary tuberculosis with no sputum or negative sputum smear and only 61 cases underwent transbronchial lung biopsy.All patients underwent sputum acid-fast staining and rapid culture for Mycobacterium tuberculosis in sp...