TB is one of bronchiectasis for common diseases, TB evolutionary process, it was reported in the literature with bronchiectasis 56% to 90%. Original hair about 15% of patients with pulmonary tuberculosis combined bronchiectasis, and chronic pulmonary tuberculosis hollow fibers are almost 100 per cent with varying degrees of bronchiectasis. 1, etiology and pathogenesis Bronchiectasis with tuberculosis, can be divided into the following types: ① childhood suffering from pleurisy, pleurodesis impact on the development of the lung, bronchial buckling, or impeded airway obstruction caused bronchiectasis; ② suffering from the syndrome of children , the bronchial wall and the lymph nodes oppression bronchial miscommunication or a lymphatic fistula, a local scar caused bronchial stenosis, obstructive airway, causing the distal bronchiectasis; ③ ENDOBRONCHIAL TB patients, airway mucosal congestion and edema, cheese and secretions and scar contracture, causing bronchial obstruction, and the distal bronchiectasis, or a change of tuberculosis caused structural damage or cause bronchial secondary inflammation, may lead to bronchiectasis; ④ infiltrating bronchial spread of tuberculosis progress so that the structure change. Recovery process sclerosis, a stretch of bronchial fibrosis, bronchiectasis is an important cause. Children suffering from tuberculosis pleurisy period due to the bronchial bronchiectasis was buckling, columnar, fascicular or cystic changes, the lumen may be inflammatory secretions retention and expansion around the bronchial inflammation may have fibrous change. Tuberculosis caused by bronchiectasis. Cartir According to statistics 50% of endobronchial lesions of tuberculosis, the majority of the bronchial expansion was columnar, and a few changes were Bunch, tuberculosis around the fibrous tissue hyperplasia and fiber cheese lesions; expansion of the distal bronchial lung tissue have disseminated tuberculosis foci. Bronchial be more traction around fibrosis or scar contracture or buckling and deformation. With the expansion can generate bronchial artery embolization, hypertrophy, expansion or distorted, and often end with the pulmonary artery anastomosis in-form arteriovenous fistula, a rupture easily hemoptysis. Second, clinical performance 1, symptoms: a child of pleurisy and other diseases caused by bronchiectasis bronchiectasis caused the same symptoms, such as repeated coughing, or cough Nongtan lot of 1,10. Bronchiectasis, pulmonary tuberculosis with less clinical manifestations, and their lesions of tuberculosis basically the same location,occurred in the upper part, a result of the Department of bronchial drainage better, relatively minor lesions, clinical symptoms are less, or even no obvious symptoms. Main performance Qinghai, a small amount of cough sputum, a small amount of hemoptysis repeatedly, and occasionally even a large number of middle-of hemoptysis. If secondary infection, it may have fever, cough purulent sputum, chest tightness Bieqi weakness or fatigue symptoms. 2, signs: Some patients may not have any positive signs. Sometimes can be heard in the location and expansion limitations blisters or dry Wong Yin Yin. Chronic severe tuberculosis hollow fibers are formed, basically with bronchiectasis, pulmonary function caused serious damage if the merger infection easily respiratory failure performance. 3, X-ray examination: This is the diagnosis of bronchiectasis one of the main instruments for serious cases of tuberculosis, chest X-ray film broad and obvious pleural thickening, lung shrinking Jinjianxi narrow trachea mediastinal shift, diaphragmatic rise, a large number of hollow fibers around hyperplasia, a weeping willow hilar raise shadow, which shows signs of bronchial has clearly changed, with a combined history can be sure of the diagnosis of bronchiectasis. When the chest X-ray on the performance of tuberculosis atelectasis, empty of tuberculosis, hollow fibers around with a large number of variable or pleural thickening on the above findings, must be highly suspected to have tuberculosis with the possibility of bronchiectasis. Zhu domestic Ermeide reported 110 cases of tuberculosis bronchiectasis in the chest X-ray of video, most of the cable shadow see 52 cases (47.3%), patchy shadows in 40 cases (36.4%), 14 cases of curling shadow (12.7%), as well as increased performance Feiwenli or atelectasis, individual without that positive. Plain film of the above-mentioned changes are non-specific, when a suspicious bronchiectasis, should do further X-ray or CT angiography or Lipiodol CT scan to diagnosis. 4, fiberoptic bronchoscopy examination: in the more than three to five bronchial bronchial discovered buckling, expand or narrow. Secretions can be learned at the same time, to find a clear cause of tuberculosis. 5, laboratory tests: some patients can be found in sputum Mycobacterium tuberculosis. A secondary infection, leukocytes in the blood can be increased, if repeated hemoptysis, have anemia blood. Third, diagnosis and differential diagnosis (1) of children suffering from TB, or tuberculosis pleurisy period bronchial lymph nodes or nuclear, as formal anti-tuberculosis treatment in a stable condition and then cropped up again, hemoptysis, expectoration, and other symptoms. (2) have a cough, expectoration or repeated symptoms hemoptysis, and blisters often fixed location sound positive signs are emerging. (3) the chest X-ray film of a cord-like, in spots, with curly hair shadow pleural thickening adhesion to the change. With the above three, with a high degree of tips bronchiectasis, and should be done Bronchography angiography or CT scan, a clear diagnosis. Tuberculosis, bronchiectasis generally good in the upper, particularly for the right upper lobe, more than two-thirds of the medial confined to the lung, often associated with bronchial stenosis distorted due to irregular wall, a twist Beads, bouquets - shaped, with bergamot, such as Chickenpaw-like morphology. Differential diagnosis should be non-tuberculous bronchiectasis of identification, the latter often congenital developmental defects or childhood Huanmachen, pneumonia, whooping cough, or have a history of chronic bronchitis, etc.. Clinical manifestations cough massive hemoptysis purulent sputum or repeated, there are clubbed fingers and toes. Auscultation:floor, the sound of small blisters. Chest X-ray showed lower lobe lesions in the basal branch, particularly the left of the more common, a mesh or curling shadow, and few bronchial stenosis. Often in the expansion of the distal bronchial or 4,5,6,7-class edges of the lung. 4, treatment Tuberculosis or poisoning of sputum positive, should first formal anti-tuberculosis treatment. Bronchiectasis, such as tuberculosis with no active tuberculosis, symptomatic treatment can be used, if secondary infection, the application of antibiotic therapy, repeated hemoptysis, ineffective internal bleeding, surgical treatment should be as soon as possible.
