在结核病诊断中通过支气管活检取取的组织样本;益处与风险
Bilal Rabahoğlu1, Nuri Tutar, Burcu Baran
1Department of Pulmonary Medicine, School of Medicine, Erciyes University, Kayseri, Turkey.
Lung India : official organ of Indian Chest Society
|September 2, 2025
概括
结核病 (TB) 的诊断通过将支气管洗 (BAL) 与支气管穿越肺部活检 (TBLB) 结合起来得到改善. 这种结合方法有助于诊断肺结核,并没有太多的并发症.
科学领域:
- 肺病学
- 传染性疾病
- 诊断程序
背景情况:
- 结核病 (TB) 是全球性的重大健康挑战,
- 支气管透镜 (BAL) 是一种常见的诊断工具,但可能并不总是产生足够的样本.
- 跨支气管肺活检 (TBLB) 可以提供组织样本,从而提高诊断产量.
研究的目的:
- 评估跨支气管肺活检 (TBLB) 在疑似肺结核 (TB) 时与支气管支气管洗 (BAL) 结合使用的诊断贡献.
- 评估结核病患者肺胸部发病率和其他与TBLB相关的并发症.
- 确定结核病诊断中结合BAL和TBLB的总体风险效益比.
主要方法:
- 在2011年3月至2018年7月期间,对可疑结核病患者的灵活光纤支气管镜检查报告进行了回顾.
- 包括606名接受了BAL和TBLB的患者.
- 数据收集包括患者的人口统计,活检部位,BAL和活检的酸性菌根 (AFB) 和培养结果,以及肺胸部等并发症.
主要成果:
- 在606名患者中,37名患者 (6. 1%) 呈阳性结核菌培养物.
- 结合BAL和TBLB增加了诊断产量,其中19名患者均呈阳性,而5名患者仅呈组织培养的阳性.
- 在34名患者中出现了肺胸炎 (5.6%),其中28名患者需要胸腔干预.
结论:
- 在适宜的情况下,BAL和TBLB的联合使用对诊断肺结核有好处.
- 该程序显示了可接受的安全性,没有显著增加重大并发症.
- 将TBLB与BAL结合在一起对肺结核的诊断准确性产生了积极影响.
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