| Objective: We aim to discuss about the clinical and bronchoscopic characteristics of endobronchial tuberculosis and the curative effect of Interventional bronchoscopy.Methods: A retrospective analysis of the clinical data about 348 cases of EBTB in the second hospital of Lanzhou university from January 2011 to December 2016.To analyze the clinical and bronchoscopic characteristics,the curative effect of Interventional bronchoscopy combining with data and the literature.Results:1.The distribution of gender and age: Of the 348 cases of EBTB,105 cases were males,and 243 cases were females,the most patients in their second and third decades of life,accounting for 26.7%.The elderly patients(61 years old and older)were 81 cases,accounting for 23.3%.2.Clinical characteristics and radiological features: 320 cases had cough which was the most common symptom,accounting for 92.0%.The duration of symptom which was more than 30 days were 299 cases,accounting for 85.9%.Computed tomography of the thorax showed that 320 cases(92.0%)had varying degree of lung invasive lesions,simple tuberculous pleurisy were 22 cases(6.3%),6cases(1.7%)of chest CT were normal.3.The region of pathological changes: In 72 cases,the disease was located in the trachea,3 cases in the bilateral bronchia,9 cases in the trachea and bilateral bronchia simultaneously.171 cases in the left,88 cases in the left main bronchus,83 cases in the left upper lobe bronchus,57 cases in the Left lower lobe bronchus,3 cases in the left main bronchus,left upper and lower lobe bronchus simultaneously.192 cases in the right,67 cases in the right main bronchus,72 cases in the right upper lobe bronchus,53 cases in the right middle segment of bronchus,54 cases in the right middle bronchus,54 cases in the right lower lobe bronchus.Lesions involving one part were 186 cases,162 cases were involved two parts and more.The maximum of 5 parts were affected.4.Subtypes: Types I of inflammatory infiltrative were 66 cases,accounting for 19.0%.Types II of ulcerous necrotic were 194 cases,accounting for 55.7%.Types III of granulomatous hyperplastic were 51 cases,accounting for 14.7%.Types IV of scar stricture were 35 cases,accounting for 10.1%.Types V of bronchomalacia were 2 cases,accounting for 0.6%.5.The resorts of acid-fast bacilli(sputum smear and secretion smear),bronchoalveolar lavage fluid culture,bronchoscopic biopsy: 348 cases of patients in this study,61 cases(17.5%)of the sputum smear using acid-fast stain were positive,150 cases(43.1%)of the secretion smear using acid-fast stain were positive,24 cases(6.9%)of bronchoalveolar lavage fluid culture were positive,102 cases(29.3%)of bronchoscopic biopsy which can observe typical granuloma were positive.6.The curative effect of interventional bronchoscopy: 210 cases of patients received interventional bronchoscopy,68 cases were males,and 142 cases were females.The subtypes included ulcerous necrotic type which were 165 cases accounting for 78.6%,39 cases were granulomatous hyperplastic type,accounting for 18.6%,6 cases were scar stricture,accounting for 2.9%.The interventional treatment included forceps holder and the local use of anti-tuberculosis drugs,174 cases were treated with this method,accounting for 82.9%,27 cases were treated with forceps holder and thermal ablation,accounting for 12.9%,3 cases were treated with thermal ablation and cryotherapy,accounting for 1.4%,6 cases were balloon dilatation,accounting for 2.9%.Ulcerous necrotic type mainly used with the treatment of forceps holder and the local use of anti-tuberculosis drugs,153 cases of ulcerous necrotic type were used with this treatment,accounting for 72.9%.The forceps holder and thermal ablation were mainly used for ulcerous necrotic type and granulomatous hyperplastic type,there were 12 cases and 15 cases respectively,accounting for 5.7% and 7.1% respectively.The treatment of thermal ablation and cryotherapy were mainly used for granulomatous hyperplastic type,there were 3 cases,accounting for 1.4%.The balloon dilatation were mainly used for scar stricture type,there were 6 cases,accounting for 2.9%.31 cases had marked effect,accounting for 14.8%,125 cases had effects,accounting for 59.5%,and 54 cases were invalid,accounting for 25.7%.The total effective rate was 74.3%.Conclusions: EBTB appears to have preponderance for females,especially in their second and third decades of life,but elderly patients have higher trend.Clinical symptoms and chest imaging were non-specific.Bronchoscope has important significance for the diagnosis,treatment and prognosis.The subtypes of bronchoscope determine the selection of the interventional treatment. |
PDF Full Text Request