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目的:评估纤维支气管镜对老年慢性阻塞性肺疾病(COPD)合并单纯性支气管结核(EBTB)患者的诊断价值及安全性。方法:回顾分析13例经纤维支气管镜确诊的65岁以上COPD合并EBTB患者的临床资料、镜下表现及病理类型。结果:13例老年患者男女比例1∶0.44,临床症状及体征无特异性。镜下检查均有异常改变,其中浸润型4例,非特异性支气管炎型4例,淋巴支气管瘘(穿孔后期)2例,溃疡型2例,增殖型1例。镜下活检6例,阳性4例;刷检13例,阳性8例;支气管灌洗9例,阳性5例。13例老年患者均顺利完成支气管镜检查,未出现严重并发症。结论:纤维支气管镜对老年COPD合并EBTB患者的诊断安全有效,活检联合刷检、灌洗,可以相互补充,提高阳性率。
Objective: To evaluate the diagnostic value and safety of fiberoptic bronchoscopy in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with simple bronchial tuberculosis (EBTB). Methods: The clinical data, microscopic findings and pathological types of 13 patients with COPD complicated with EBTB diagnosed by bronchofibroscopy were retrospectively analyzed. Results: The ratio of male to female in 13 elderly patients was 1: 0.44. The clinical symptoms and signs were not specific. Microscopic examination had abnormal changes, including infiltration of 4 cases, 4 cases of nonspecific bronchitis, lymph bronchial fistula (late perforation) 2 cases, 2 cases of ulceration, 1 case of proliferative. Microscope biopsy in 6 cases, positive in 4 cases; brush examination in 13 cases, positive in 8 cases; bronchial lavage in 9 cases, positive in 5 cases. Thirteen elderly patients were successfully completed bronchoscopy, no serious complications. Conclusion: The bronchofiberscopy is safe and effective for the diagnosis of elderly patients with COPD and EBTB. The biopsy combined with brushing and lavage can complement each other and increase the positive rate.