{Reference Type}: Review
{Title}: [Annual progress of interventional diagnosis and treatment of tuberculosis in 2023].
{Author}: Yang S;Guo JQ;Li TX;Tang SJ;
{Journal}: Zhonghua Jie He He Hu Xi Za Zhi
{Volume}: 47
{Issue}: 4
{Year}: 2024 Apr 12
暂无{DOI}: 10.360/cma.j.cn112147-20231114-00308
{Abstract}: A series of studies on the interventional diagnosis and treatment of tuberculosis(TB)were carried out by domestic and foreign researchers in 2023. The combination of minimally invasive interventional procedures with endoscopes, guidance, material acquisition techniques by multiple ways and multichannel and highly accurate laboratory testing techniques is becoming more and more widely practiced clinically, which has played an important role in the accurate diagnosis of problematic TB. Diagnostic procedures for pulmonary TB, tracheobronchial TB, mediastinal lymphatic TB and extrapulmonary TB included conventional flexible bronchoscopy and specific types of bronchoscopy(ultrathin bronchoscopy and endobronchial ultrasound), transbronchial needle aspiration biopsy, endobronchial ultrasound and virtual bronchoscopic navigation system-guided forceps biopsy, thoracoscopic cryobiopsy of pleura, percutaneous biopsy, and so on. The time to diagnosis has been significantly reduced and the diagnostic efficacy has been improved by the clinical specimen detection using either Gene Xpert MTB/RIF, Ultra, loop-mediated isothermal amplification, metagenomic next-generation sequencing, or nanopore sequencing, etc. Interventional therapy was focused on the following diseases: pulmonary TB with massive hemoptysis, tracheobronchial TB, pleural TB and TB-related fistulas. Interventional treatment of tracheobronchial TB mainly included the application of rigid bronchoscopy, bronchoscopic cold and thermal ablation treatment, endoscopic clamp, dilatations of narrow airway with balloon and stent placement, etc. The interventional treatment of pulmonary TB complicated by massive hemoptysis included endovascular embolization, coated stent placement, etc. Interventional treatment of pleural TB involved the application of thoracoscopy, endoscopic forceps, the implantation of stent and other occlusive devices and the closure of fistulas with autologous fat transplantation. In this article, we reviewed the progress of interventional diagnosis and treatment of TB by the search of published literatures from October 2022 to September 2023.<BR>2023年，国内外同道在结核病的介入诊治方面进行了一系列的研究和探索。经多途径、多腔道内窥镜检下的微创介入、导航技术等引导下取样及高准确度的实验室检测技术的临床联用越来越广泛，为疑难结核病的精准诊断发挥了重要作用。针对肺结核、气管支气管结核、纵隔淋巴结结核及肺外结核的诊断技术，包括经传统的可弯曲常规支气管镜、超细支气管镜、超声支气管镜等特殊类型支气管镜检术，经支气管镜透壁针吸活检术、超声及虚拟导航等引导下活检技术，经胸腔镜胸膜冷冻活检术，经皮穿刺活检等技术。经介入技术取样标本的Xpert、Ultra、环介导等温扩增、宏基因组学二代测序及纳米孔测序等技术，显著缩短了诊断的时限并提高了诊断效能。介入治疗集中在肺结核大咯血、气管支气管结核、胸膜结核与结核相关瘘等疾病。气管支气管结核的介入治疗主要包括硬镜的应用，肺结核大咯血的介入治疗涉及血管内栓塞、覆膜支架置入等；经支气管镜冷热消融技术、狭窄气道的球囊扩张及支架置入术等；胸膜结核的介入治疗有胸腔镜技术，经内镜钳夹、支架等封堵器置入及自体脂肪移植等瘘口封堵术。本文就2022年10月至2023年9月已发表的文献进行综述。.