| 赵戊辰,徐旭东,叶波,陈达.肺曲霉病患者42例临床分析[J].浙江中西医结合杂志,2019,29(7): |
| 肺曲霉病患者42例临床分析 |
| Analysis of 42 Cases of Pulmonary Aspergillosis |
| 投稿时间：2019-01-05 修订日期：2019-02-15 |
| DOI： |
| 中文关键词: 肺曲霉病 、外科治疗、咯血、介入 |
| 英文关键词:Pulmonary Aspergillosis, Surgical Treatment, Hemoptysis, Intervention |
| 基金项目:浙江省医药卫生科研A类计划 |
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| 中文摘要: |
| 目的：探讨肺曲霉病患者的临床、影像学表现,分析内外科不同治疗方法在肺曲霉病患者的作用。方法：选取本院2013.6~2018.6年经病理或培养确诊为肺曲霉病的住院患者42例,分析其临床表现、影像学、诊断及治疗情况。结果：42例患者中,经外科手术切除共25例,术后出现咯血4例,2例经介入治疗后好转,2例经药物治疗后好转,其余患者术后恢复良好,无复发。非手术患者17例,死亡患者1例,其余药物保守治疗或介入治疗后好转。主要症状中咯血患者29例(69.0％),其中19例患者经介入治疗后无再发咯血(65.5％),2例患者有反复介入治疗史,均为非手术患者。本组病例多合并有其他肺部疾病,其中合并肺结核36例(85.7％),支气管扩张18例(42.9％),肺部感染4例(9.5％),肺气肿2例(4.8％)。影像学表现不同类型,新月征占13例(30.9％),空洞型22例(52.4％)、肿块结节型5例(11.9％)。手术患者除1例出现支气管胸膜瘘外,其余患者恢复较好,非手术组出现反复咯血者较多。结论：肺曲霉病常与其他肺部疾病并发,临床症状缺乏特异性,影像学表现除新月形外,亦无特异性表现,根据患者不同病情合理选择治疗方法可达到较好的疗效,介入可作为咯血治疗方法之一大力推广。 |
| 英文摘要: |
| Objective: To investigate the clinical and imaging findings of patients with pulmonary aspergillosis and to analyze the effects of different treatments of internal and external surgery on patients with pulmonary aspergillosis. Methods: Forty-two inpatients diagnosed as pulmonary aspergillosis by pathology or culture in our hospital from June 2013 to June 2018 were enrolled. The clinical manifestations, imaging, diagnosis and treatment were analyzed. Results: Of the 42 patients, 25 patients underwent surgical resection, 4 patients had hemoptysis after operation, 2 patients improved after interventional therapy, and 2 patients improved after drug treatment. The other patients recovered well after surgery without recurrence. There were 17 non-surgical patients and 1 died, and the rest were improved after conservative + interventional therapy. Among the main symptoms, 29 patients (69.0%) had hemoptysis, 19 of whom had no further hemoptysis after intervention (65.5%), and 2 patients had a history of repeated interventions, all of whom were unsurgical. There were other lung diseases in this group, including 36 cases (85.7%) with tuberculosis, 18 cases (42.9%) with bronchiectasis, 4 cases (9.5%) with pulmonary infection, and 2 cases (4.8%) with emphysema. There were different types of imaging findings, including 13 cases (30.9%) with new moon, 22 cases (52.4%) with cavities, and 5 cases (11.9%) with nodular nodules. Except for 1 case of bronchial pleural effusion, the other patients recovered better, and there were more hemoptysis in non-surgical group. Conclusion: Pulmonary aspergillosis is often complicated with other lung diseases, and the clinical symptoms are lack of specificity. The imaging findings are not specific to the crescent shape. It is better to choose a treatment according to different conditions of the patient. Can be promoted as one of the hemoptysis treatment methods. |
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