| 李柏颖,蔡闯,鲍志坚,方毕飞,徐俭朴.支气管镜局部灌注伏立康唑治疗肺曲菌球3例并文献复习[J].浙江中西医结合杂志,2014,24(9): |
| 支气管镜局部灌注伏立康唑治疗肺曲菌球3例并文献复习 |
| 3 cases report and literature review of Bronchoscopic local perfusion of voriconazole in the treatment of pulmonary aspergillomaLI Bai-ying1,CAI Chuang1,BAO Zhi-jian1,FANG Bi-fei1,XU Jian-pu1* |
| 投稿时间：2013-09-04 修订日期：2013-12-14 |
| DOI： |
| 中文关键词: 肺曲菌球,伏立康唑,介入治疗 |
| 英文关键词: |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨经支气管镜局部灌注伏立康唑的治疗肺曲菌球的疗效、安全性。方法 报告3例经支气管镜局部灌注伏立康唑治疗的肺曲菌球病例,观察该治疗方法的疗效、安全性,并对近20年来国内外的文献进行复习。结果 3例患者经过4周8次的局部灌注伏立康唑治疗后咯血停止,复查CT显示曲菌球缩小或消失。目前4例患者均在随访过程中,未再出现咯血。国内外文献显示,肺曲菌球的治疗仍以手术及随访为主；支气管动脉栓塞术是控制肺曲菌球大咯血最常用的手段,但远期疗效欠佳；文献报道局部灌注抗真菌药物治疗肺曲菌球两例,分别选用酮康唑和伊曲康唑作为治疗药物,结果显示病灶菌明显吸收,未发现严重不良反应。结论 支气管镜局部灌注伏立康唑治疗肺曲菌球是一种值得推广的治疗方法。 |
| 英文摘要: |
| Objective To explore the safety and efficacy of Bronchoscopic local perfusion of voriconazole in the treatment of pulmonary aspergilloma. Methods 3 cases of Bronchoscopic local perfusion of voriconazole in the treatment of pulmonary aspergilloma were reported.The curative effect and safety of the treatment method were observed and the related literature in recent 20 years were reviewed. Results The 3 cases after local infusion of voriconazole 8 times in 4 weeks, hemoptysis disappear, review the CT display aspergilloma was significantly reduced or disappeared. At present, the 3 patients are during follow-up, no hemoptysis. The literature review shows treatment of pulmonary aspergilloma is still dominated by operation and follow-up; bronchial artery embolization is the most commonly used in hemoptysis, but the long-term efficacy is poor; local perfusion of antifungal agents in the treatment of pulmonary aspergilloma in two cases, ketoconazole and itraconazole werecused respectively. The results showed the lesions were reduced obviously, no serious adverse reaction was found. Conclusion Bronchoscopy local perfusion of voriconazole in the treatment of pulmonary aspergilloma is a worthy of promotion therapy method. |
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