Tuberculosis and Respiratory Diseases
- 제38권4호
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- Pages.340-346
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- 1991
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- 1738-3536(pISSN)
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- 2005-6184(eISSN)
기관 및 기관지 결핵 61예의 임상적 고찰
A Clinical Study on 61 Cases of Tuberculous Tracheobronchitis
- 안철민 (연세대학교 의과대학 내과학교실) ;
- 김형중 (연세대학교 의과대학 내과학교실) ;
- 황의석 (연세대학교 의과대학 내과학교실) ;
-
김성규
(연세대학교 의과대학 내과학교실) ;
- 이원영 (연세대학교 의과대학 내과학교실) ;
- 김상진 (연세대학교 의과대학 방사선과학교실)
- Ahn, Chul-Min (Department of Internal medicine, Yonsei University Collage of Medicine) ;
- Kim, Hyung-Jung (Department of Internal medicine, Yonsei University Collage of Medicine) ;
- Hwang, Eai-Suk (Department of Internal medicine, Yonsei University Collage of Medicine) ;
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Kim, Sung-Kyu
(Department of Internal medicine, Yonsei University Collage of Medicine) ;
- Lee, Won-Young (Department of Internal medicine, Yonsei University Collage of Medicine) ;
- Kim, Sang-Jin (Department of Radiology, Yonsei University Collage of Medicine)
- 발행 : 1991.12.31
초록
Tuberculous tracheobronchitis is defined as a specific inflammation of the trachea or major bronchi caused by the tubercle bacillus and recognized as one of the most common and serious complication of pulmonary tuberculosis. It had been a diagnostic challenge in prebronchoscopic era and since 1968, fiberoptic bronchoscopy has been accepted as a safe and valuable diagnostic procedure of tuberculous tracheobronchitis. Now, it remains a troublesome therapeutic problem due to its sequelae such as bronchostenosis, bronchiectasis and bronchial deformity. The authors analyzed the clinical features, radiological findings and bronchoscopic findings with pathologic and bacteriologic study on 61 cases of tuberculous tracheobronchitis and following results were obtained. 1) The peak incidence was in the fourth decade and male to female ratio was 1:3.4. 2) The most common symptom was cough (86.9%) and followed by sputum (49.2%), dyspnea (27.9%), fever (19.8%), weight loss (11.5%), hemoptysis (6.6%), hoarseness (6.6%) and chest discomfort (3.3%) and localized wheezing was heard in 18%. 3) In chest X-ray, consolidation with collapse was observed in 70.5%, and followed by consolidation only (18.0%), mediastinal node enlargement (8.2%), cavitary lesion (6.6%), suspicious hilar mass (3.3%) and miliary lesion (1.6%) and there was no abnormal findings in 4.9%. 4) Bronchoscopy showed hyperplastic lesion in 67.2%, mucosal lesion (18.0%), ulcerative lesion (9.8%) and stenotic lesion (4.9%). The most common site of bronchial lesion was right upper bronchus (36.1%) and followed by right main bronchus (34.4%), left main bronchus (29.5%), left upper bronchus (16.4%), right middle bronchus (8.2%), right lower bronchus (6.6%) and left lower bronchus (3.3%). 5) Chronic granulomatous inflammation with or without caseation necrosis on microscopic examination was confirmed in 69.7%, bronchial washing AFB stain was positive in 34.1%, prebronchoscopic sputum AFB stain was positive in 88.1% and postbronchoscopic sputum AFB stain was positive in 30.1%.
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