Retrospective Analysis And Research Of Clinical Data For 35 Cases Of Bronchial Tuberculosis In A Single Center

Objective:To explore the general clinical features,imaging and bronchoscopic manifestations of tracheobronchial tuberculosis,analyze the distribution relationship between various factors and different pathological types,and compare the clinical features and imaging manifestations of pulmonary tuberculosis patients,so as to provide ideas for clinical diagnosisMethods:Hospitalized patients diagnosed with bronchial tuberculosis were collected for general clinical data,clinical performances,imaging and bronchoscope alterations,and histopathological changes between January 2010 and April 2016 in the first hospital affiliated to Zhejiang university of medicine.Thirty-five patients diagnosed with tuberculosis in the same period(excluding patients younger than 18 years old with incomplete clinical data and those with underlying immunodeficiency or severe coagulation disorder)were selected as the control group,and the clinical characteristics and imaging manifestations of the two groups were compared.Results:All 35 patients including were diagnosed by bronchoscope histopathology.The age range in patients was 20?80 years old,with an average of 48.7 ± 17.8years old.The ratio of male to female was 2:3.The average duration before treatment was 65.35± 19.55days.The main clinical performances in patients were cough,expectoration(71.4%);There was no statistical difference in gender,age and course of disease in the control group of tuberculosis.There was no statistically significant difference(P>0.05)in the symptoms of cough,expectoration,chest pain,chest tightness,shortness of breath,tolerance,nausea,vomiting,abdominal pain,abdominal distension,and other gastrointestinal symptoms(P<0.05),but there were statistically significant differences in fever and throat foreign body sensation between the two groups(P<0.05).26 patients had pulmonary tuberculosis(74.3%)simultaneously.Pulmonary tuberculosis group(n=35)were diagnosed by sputum culture.There were 15 male patients(42.9%),20 female patients(57.1%),and the mean age of the patients was 49.6±16.9 years old.The clinical manifestations were as follows:cough and expectoration in 28 cases(80%),partly accompanied by fever.There was no significant difference in sex,age and course of disease between the two groups.Clinical symptoms of cough,expectoration,chest pain,chest tightness or post-exercise dyspnea,fatigue,anorexia,nausea,vomiting or abdominal pain,abdominal distension,etc.There was no significant difference in symptoms and clinical manifestations between the two groups(P>0.05),but there were significant differences in fever,hemoptysis and foreign body sensation in pharynx and larynx between the two groups(P<0.05).In the group of tracheobronchial tuberculosis,there were 13 cases of local infection,8 cases of suspected pulmonary tuberculosis,8 cases of suspected foreign body or stenosis of bronchus and 6 cases of pulmonary space occupying lesions in the group of tracheobronchial tuberculosis.Bronchoscopy:inflammatory infiltration in 10 cases(29%),ulcer necrosis in 14(40%),granulation proliferation in 8(23%),scar stenosis in 3(9%),and inflammatory infiltration in 10(29%),ulcer necrosis in 14(40%),granulation proliferation in 8(23%)and scar stenosis in 3(9%).In the pulmonary tuberculosis group,14 cases were initially diagnosed as local infection,16 cases were suspected of pulmonary tuberculosis,5 cases were pulmonary space occupying lesions,and there was no significant difference between the two groups(P But there was significant difference between the two groups in nodular change,foreign body or stenosis of bronchus,and partial obstructive change(P<0.05),but there was no significant difference between the two groups(P<0.05).Conclusion:Compared with patients with pulmonary tuberculosis,the symptoms of fever and hemoptysis in patients with tracheobronchial tuberculosis were more atypical,and some patients could feel foreign matter in pharynx and larynx.Bronchial stenosis is a relatively characteristic change in endobronchial tuberculosis,especially in patients with simple endobronchial tuberculosis.The bronchus of the middle lobe of the right lung is the most frequent imaging siteBronchial tuberculosis and pulmonary tuberculosis are frequently coinstantaneous in young and middle-aged patients,More women than men are inclined to suffer bronchial tuberculosis.