骨化性气管支气管病并肺结核漏诊原因分析并文献复习

摘要

Objective To investigate clinical characteristics and missed diagnosis causes of tracheobronchopathia osteochondroplastica (TO) complicated by pulmonary tuberculosis (PTB) in order to improve levels of diagnosis and treatment.Methods Clinical data of 1 patient with TO complicated by PTB was retrospectively analyzed.Results The patient visited a doctor for repeated cough and expectoration for one and a half years, and aggravation associated by chest pain for 1 month.He had been diagnosed as having trachea-bronchus tuberculosis combined with pulmonary tuberculosis in other hospital, and was treated with anti-tuberculosis drugs and bronchoscopic cryotherapy and local drug injection, but his symptoms did not be relieved.He was confirmed the diagnosis of TO complicated by right upper pulmonary tuberculosis by tuberculin test, tuberculosis-antibody test, chest CT, bronchoscopy and biopsy pathological examinations in our hospital, and treatments of anti-tuberculosis drugs and bronchoscopic argon ion laser were given, and then the patient discharged after his symptoms had improved.Anti-tuberculosis treatment was given continuously after discharge, and no new lesions were found by regularly review.Conclusion It is the key to performing high-resolution chest CT test, bronchoscopy and multiple times and positions of biopsy pathological examinations in diagnosis of highly suspected TO patients.%目的 探讨骨化性气管支气管病(tracheobronchopathia osteochondroplastica, TO)并肺结核的临床特点及漏诊原因,提高诊治水平.方法 对我院收治的TO并肺结核1例的临床资料进行回顾性分析.结果 本例因反复咳嗽、咳痰1年半,加重伴胸痛1个月就诊.曾在外院就诊,诊断为气管支气管结核并肺结核,予抗结核及支气管镜下冷冻及局部注药治疗,症状未见缓解.入院后行结核菌素试验、结核抗体检查、胸部CT、支气管镜及活组织病理检查等,确诊为TO并右上肺结核,予抗结核及支气管镜下氩气刀治疗,患者症状好转出院.后继续抗结核治疗,定期复查,未见新发病灶.结论 对高度怀疑TO的患者,及时行胸部高分辨率CT和支气管镜及多次多部位活组织病理检查是确诊的关键.