THE CONTRIBUTION OF THE FIBEROPTIC BRONCHOSCOPY IN DIAGNOSING OF SMEAR NEGATIVE PULMONARY TUBERCULOSIS
Autori:
Boris Vrga
Sažetak
U radu su analizirane uloga i važnost fiberbronhoskopije u ranoj i konačnoj dijagnozi aktivne tuberkuloze pluća u 102 bolesnika liječena u razdoblju od 1. siječnja 2007. do 31. prosinca 2012. godine na Odsjeku za plućne bolesti Opće bolnice »Dr. Ivo Pedišić« u Sisku – lokacija Petrinja, a čiji su inicijalni uzorci sputuma bili direktno negativni na acidorezistentne bacile. Analizirana je dijagnostička uspješnost pojedinih bronhoskopskih procedura, kao i njihovih kombinacija. Rana dijagnoza aktivne tuberkuloze pluća postavljena je kod 31 bolesnika (30,39%), a konačna dijagnoza kod 67 bolesnika (65,68%). Dijagnoza aktivne plućne tuberkuloze postavljena je jedino na bazi uzoraka uzetih tijekom fiberbronhoskopije kod 28 bolesnika (9,65%). Statistički značajan broj bolesnika u kojih je dijagnoza postavljena fiberbronhoskopijom ističe važnost ove metode u dijagnostici aktivne tuberkuloze pluća u bolesnika čiji su sputumi mikroskopski direktno negativni i/ili u onih koji ne mogu spontano iskašljati primjeren uzorak.
Summary
The study has analysed the role and significance of fibrobronchoscopy in the early and definitive diagnosis of active pulmonary tuberculosis in 102 patients treated on the Pulmonary Ward of ‘Dr Ivo Pedišić’ hospital in Sisak – location Petrinja from 1st January 2007 to 31st December 2012 and whose initial sputum specimens directly tested negative for acid resistant bacilli. What has been analysed is the diagnostic efficiency of particular bronchoscopic procedures themselves and their combinations. An early diagnosis of active tuberculosis has been made in 31 patients (30,39%), and definitive diagnosis in 67 patients (65,68%). The etiological diagnosis of active pulmonary tuberculosis has been made only on the basis of specimens taken during fibrobronchoscopy in 28 patients (9,65%). A statistically significant number of patients in whom diagnosis has been made by fibrobronchoscopy emphasizes the importance of this method in the etiological diagnostics of active pulmonary TB in those patients whose sputum samples are microscopically directly negative and/or in those who cannot spontaneously expectorate valid sputum.
