纤维支气管镜冲洗对痰涂片阴性肺结核的诊断率

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

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