| Objective:The purpose of this paper was to explore the clinical characteristics,diagnosis, treatment and the value of bronchoscopy in the diagnosis ofbronchial tuberculosis in children,and explore the therapeutic effect offiber bronchoscope on bronchial tuberculosis.Methods：According to the diagnositic criteria of《Zhu Futang TextbookPediatrics》,we enroll36patients,who were definitely diagnosed as EBTB,admitted in pediatric respiratory in the1sthospital of Jilin Universityduring January2008to October2015.Diagnose the disease through thelesion of local tissue observing under bronchofibroscope and pathologicalbiopsy.At the same time,bronchoscope and interventional techniqueswere given to treat EBTB. Recheck bronchofibroscope in1week to4years. Clinical data including the generalcondition, clinicalmanifestations, the results of accessory examinations includingbronchoscopy results, treatment and follow-up prognosis wereretrospectively analyzed. The results of accessory examinations includingbronchoscopy results, treatment and follow-up prognosis wereretrospectively analyzed. Result:1.Among the36patients of endobrochial tubercolosis,18cases werebaby boys and18cases were baby girls. Onset age from6months to17years,average age（7.23±5.03）.There was no statistically significandifference of male and female ratio in children with different ages（P＞0.05）.2.All case have cough,28cases have irritable cough,27case withfever,5case with wheeze,6case with chest tightness,4cases with dyspnea,2case with hemoptisis.3.Among the36cases of endobrochial tubercolosis,there were18cases with tuberculosis,1case with merger laryngeal,1case with spleenand lymph node TB,9cases with merger pleural effusion and mergepentioneal effusion in1case,9case with with pneumonia leasions,10caseswith atelectasis.4.Before the fiber bronchoscope diagnosis,pneumonia werediagnosed in23cases,2cases as bronchial foreign body,1case asbronchial asthma, hemoptysis in dispute in2cases.5.36cases were underwent chest radiographs and/or chest CT,11cases of EBTB wer suspected. Both joint pathology via fiberopticbronchoscopy examination in order to make diagnosis clear in ourhospital.6.The microscopic points in17cases of granulation proliferative （typeⅢ）,10cases of scar stricture （typeⅣ）,3cases of inflammatoryinfiltration type（typeⅠ）,2cases of ulcer type necrosis（typeⅡ）,1casesof lymph node type fistual（typeⅥ）.1case occured in the mainbronchus,5cases in right main bronchus,5cases in upper rightbronchus,1case in the middle period of bronchus,6cases in the rightmiddle bronchus,4cases in the right bronchus,3cases in the left mainbronchus,3in the upper left bronchus,1case in tongue lobebronchus,7cases in the lower left bronchus.7.In the microscopy technique, according to the microscopiccondition to the local administration,alveolar lavage joint, freezing, laser,such as argon, balloon dilatation therapy were used to treat EBTB. In the36cases,1case died with tuberculous meningitis.For children withbronchial tuberculosis after confirmed were treated in the tuberculosishospital, in children with36cases,15cases have already lost. The20cases who were treated by bronchoscope and intervention technique,13cases have been cured,7cases in the recovery of EBTB.Via telephonefollow-up,7cases in anti-tuberculosis treatment is still in the system.Conclusions:1.EBTB in children always presents long course of disease,ruralchildren were much higher than that of children in cities and towns.Theclinical manifestation of EBTB is not typical,mainly with cough andexpectoration.Highly attention should be paid to childrens with chronic excitant cough as it may remind of EBTB.2.Bronchofibroscope is an extremely important means for thediagnosis of EBTB in children.3.Bronchofibroscope and interventional therapy are effective on thetreatment of pediatric EBTB. |
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