Diagnostic Yield of Fiberoptic Bronchoscopy Washings among Patients of Sputum Smear Negative Pulmonary Tuberculosis

Muhammad Nusrullah, Afeera Hamid, M. Rashid, H. Waqas, Abdul Rauf
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Abstract

Fiberoptic bronchoscopy with bronchial washing is done for diagnosis of pulmonary tuberculosis among patients who cannot produce sputum spontaneously. Aim: To evaluate the diagnostic yield of Fiberoptic Bronchoscopy for detection of positive cases in cases of Smear negative pulmonary tuberculosis. Study Design: Cross-sectional study. Methodology: All patients (n=80) were advised NPO for 6 hours before carrying out the procedure. It was done using local anesthesia while retrievement of the instilled amount by 25% was considered successful. The bronchial washings were sent for AFB staining in-order to confirm the presence or absence of Mycobacterium Tuberculosis. Bronchial washing smear was considered positive if 1-9 AFB/HPF are seen on direct microscopy. Statistical Analysis: SPSS v.26 analyzed the data. Stratification of diagnostic yield was done with respect to age and gender. Post stratification Chi-Squire test was applied with P-value ≤0.05 was taken as significant. Results: The diagnostic yield of FOB for detection of positive cases in cases of Smear negative PTB was 57.5%. The highest diagnostic yield was seen in patients in the age group 16-32 and 49-60 years old patients i.e. 37% in both groups. For both genders diagnostic yield for FOB was 50%. However patient’s age and gender were insignificantly associated with diagnostic yield of FOB. Conclusion: It was concluded that FOB can provide a rapid and definitive diagnosis of pulmonary tuberculosis in sputum negative patients. Keywords: Diagnostic Yield, Fiberoptic Bronchoscopy, Smear Negative and Pulmonary Tuberculosis.
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纤维支气管镜冲洗对痰涂片阴性肺结核的诊断率
纤维支气管镜与支气管冲洗是诊断肺结核的病人不能自发产生痰。目的:评价纤维支气管镜检查对涂阳肺结核阳性病例的诊断率。研究设计:横断面研究。方法:所有患者(n=80)在手术前6小时建议NPO。采用局麻,取注量25%为成功。支气管洗涤送去AFB染色,以确定是否存在结核分枝杆菌。如果在直接显微镜下看到1-9个AFB/HPF,则认为支气管洗涤涂片呈阳性。统计分析:SPSS v.26对数据进行分析。诊断产率按年龄和性别分层。分层后采用Chi-Squire检验,p值≤0.05为差异有统计学意义。结果:对涂片阴性肺结核阳性病例的FOB诊断率为57.5%。16-32岁和49-60岁患者的诊断率最高,两组均为37%。男女的FOB诊断率均为50%。然而,患者的年龄和性别与FOB的诊断率无显著相关。结论:对痰液阴性的肺结核患者,超声心动图能提供快速、明确的诊断。关键词:诊断率,纤维支气管镜检查,涂片阴性,肺结核。
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