论著
ENGLISH ABSTRACT
252例儿童气管支气管结核分型探讨
刘芳
饶小春
马渝燕
孟辰芳
潘跃娜
刘涵
申阿东
焦安夏
作者及单位信息
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DOI: 10.3760/cma.j.cn112147-20210624-00444
Classification of tracheobronchial tuberculosis in 252 children
Liu Fang
Rao Xiaochun
Ma Yuyan
Meng Chenfang
Pan Yuena
Liu Han
Shen Adong
Jiao Anxia
Authors Info & Affiliations
Liu Fang
Department of Interventional Pulmonology, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health(NCCH), Beijing 100045, China
Rao Xiaochun
Department of Interventional Pulmonology, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health(NCCH), Beijing 100045, China
Ma Yuyan
Department of Interventional Pulmonology, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health(NCCH), Beijing 100045, China
Meng Chenfang
Department of Interventional Pulmonology, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health(NCCH), Beijing 100045, China
Pan Yuena
Department of Interventional Pulmonology, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health(NCCH), Beijing 100045, China
Liu Han
Imaging Center, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health(NCCH), Beijing 100045, China
Shen Adong
Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health (NCCH), Beijing 100045, China
Jiao Anxia
Department of Interventional Pulmonology, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health(NCCH), Beijing 100045, China
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DOI: 10.3760/cma.j.cn112147-20210624-00444
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摘要

目的分析儿童气管支气管结核(tracheobronchial tuberculosis,TBTB)的临床特点、支气管镜下分型及治疗效果,为儿童TBTB的早期诊断、准确分型提供理论依据。

方法回顾性分析2006年1月至2019年12月首都医科大学附属北京儿童医院收治入院并进行了支气管镜检查的TBTB患儿的基本资料、临床表现、影像学特征、支气管镜下特点、介入治疗效果。对研究结果使用SPSS 22.0统计学软件对相关数据进行统计学描述与分析。

结果252例TBTB患儿的中位年龄为1.7(0.8,5.2)岁。在TBTB的分型中,淋巴结瘘型TBTB患儿占96.4%(243/252)、溃疡坏死型1.2%(3/252)、肉芽增殖型0.4%(1/252)、瘢痕狭窄型0.8%(2/252),此外,1.2%(3/252)的TBTB患儿支气管镜下表现与淋巴结瘘型相同,但影像学上无法明确管腔内干酪样物质是淋巴结破溃所致,不除外干酪性肺炎相关的肺-支气管瘘可能,故提出“支气管瘘型”。

结论淋巴结瘘型是儿童最常见的TBTB类型,介入治疗效果显著,但此分型若要明确瘘口来自纵隔或肺门淋巴结,需要依赖影像学证据,临床中可能存在分型不明确的情况。

结核;支气管镜检查;分型;儿童
ABSTRACT

ObjectiveTo provide theoretical basis for early diagnosis and accurate bronchoscopic classification of tracheobronchial tuberculosis (TBTB) in children through analyzing the clinical characteristics, bronchoscopic classifications and treatment effect in children with TBTB.

MethodsIn this respective study, we collected clinical data of patients with TBTB who accepted bronchoscopies in Interventional Pulmonology Department of Beijing Children′s Hospital Affiliated to Capital Medical University between January, 2006 and December, 2019. The basic data, including clinical manifestations, imaging features, bronchoscopic characteristics and effects of interventional therapy were analyzed. The results of the study were statistically described and analyzed using SPSS 22.0 statistical software for relevant data.

ResultsTotal 252 children with TBTB were included in this study. The median age was 1.7 years (quartile: 0.8 years, 5.2 years). Analysis of the classification of TBTB showed that the percent of lymph node fistula type was 96.4% (243/252), ulcerative necrosis type 1.2%(3/252), granulation proliferation type 0.4% (1/252), and cicatricial stricture type 0.8% (2/252). In addition, 1.2% (3/252) of the cases showed the same bronchoscopic manifestations as lymph node fistula type, but it was not clear on imaging whether the caseous material in the lumen was caused by lymph node or lung erosion. Therefore, the "bronchial fistula type" was proposed.

ConclusionsLymph node fistula type of TBTB was the common in children. The classification of lymph node fistula mostly depended on imaging evidence, and this may lead to some uncertainty in classifying TBTB in cases with no imaging evidence of enlarged lymph nodes.

Tuberculosis;Bronchoscopy;Classification;Children
Shen Adong, Email: mocdef.labiamtoh61danehs
Jiao Anxia, Email: mocdef.nabuyilaoaijaixna
引用本文

刘芳,饶小春,马渝燕,等. 252例儿童气管支气管结核分型探讨[J]. 中华结核和呼吸杂志,2022,45(03):282-288.

DOI:10.3760/cma.j.cn112147-20210624-00444

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评价本文
*以上评分为匿名评价
气管支气管结核(tracheobronchial tuberculosis,TBTB)是儿童肺结核的常见类型。支气管镜对明确TBTB的诊断及TBTB的介入治疗具有重要价值。TBTB根据支气管镜下观察到的大体改变及组织病理学特征分为 1:炎症浸润型、溃疡坏死型、肉芽增殖型、瘢痕狭窄型、管壁软化型和淋巴结瘘型。淋巴结瘘型是儿童最常见的类型 2 , 3 , 4。TBTB的分型对TBTB的介入治疗与预后评估有重要价值 5。目前关于儿童TBTB的临床研究很少,现有的部分研究存在分型不明确的问题。本研究通过分析252例儿童TBTB的临床特点、支气管镜下分型特点及介入治疗效果,提高临床医师对儿童TBTB的认识和理解,为儿童TBTB的早期诊断、准确分型以及介入治疗提供理论依据。
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备注信息
A

刘芳:数据整理、论文撰写;饶小春、马渝燕、孟辰芳、潘跃娜:数据收集、论文修改、统计学分析;刘涵:影像资料分析;申阿东、焦安夏:研究指导、论文修改

B
申阿东,Email: mocdef.labiamtoh61danehs
C
焦安夏,Email: mocdef.nabuyilaoaijaixna
D

刘芳, 饶小春, 马渝燕, 等. 252例儿童气管支气管结核分型探讨[J]. 中华结核和呼吸杂志, 2022, 45(3): 282-288. DOI: 10.3760/cma.j.cn112147-20210624-00444.

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