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34例肺曲霉菌病的外科治疗

何嘉 陈野野 李单青

何嘉, 陈野野, 李单青. 34例肺曲霉菌病的外科治疗[J]. 协和医学杂志, 2014, 5(3): 318-322. doi: 10.3969/j.issn.1674-9081.2014.03.014
引用本文: 何嘉, 陈野野, 李单青. 34例肺曲霉菌病的外科治疗[J]. 协和医学杂志, 2014, 5(3): 318-322. doi: 10.3969/j.issn.1674-9081.2014.03.014
Jia HE, Ye-ye CHEN, Shan-qing LI. Surgical Treatment for Pulmonary Aspergillosis: Report of 34 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(3): 318-322. doi: 10.3969/j.issn.1674-9081.2014.03.014
Citation: Jia HE, Ye-ye CHEN, Shan-qing LI. Surgical Treatment for Pulmonary Aspergillosis: Report of 34 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(3): 318-322. doi: 10.3969/j.issn.1674-9081.2014.03.014

34例肺曲霉菌病的外科治疗

doi: 10.3969/j.issn.1674-9081.2014.03.014
详细信息
    通讯作者:

    李单青 电话:010-69152630, E-mail:lsq6768@sohu.com

  • 中图分类号: R655.3

Surgical Treatment for Pulmonary Aspergillosis: Report of 34 Cases

More Information
  • 摘要:   目的  探讨外科手术治疗肺曲霉菌病的原则、方法及效果。  方法  回顾性分析北京协和医院1986年1月至2013年12月经手术治疗的34例肺曲霉菌病患者的临床资料及随访结果。3例CT表现为弥漫性病变的患者采用肺楔形切除术获得病理组织; 31例局限性病变患者均行病变完整切除, 其中肺叶切除术26例, 肺段切除术3例, 肺楔形切除术2例。27例行开胸手术, 7例行胸腔镜手术。  结果  无手术死亡病例, 所有病例均由病理诊断为曲霉菌感染。术后出现并发症的患者5例(14.7%), 分别为肺栓塞1例, 急性肺水肿1例, 胸腔积液1例, 支气管胸膜瘘1例, 切口裂开1例。术后2~34 d出院, 平均住院时间(10.1±6.2)d。随访1~16年, 全部治愈, 无复发。  结论  对于弥漫性肺部病变怀疑肺曲霉菌病无法明确诊断时, 手术肺组织活检可提供病理及病原学诊断的金标准; 对于局限性肺曲霉菌病变, 外科手术可将病灶完整切除, 提供明确的病理诊断, 并有效缓解症状, 避免复发。
  • 图  1  肺曲霉菌病患者的典型CT表现

    A.右肺上叶前段局限性簇样多发囊状扩张支气管影,纵隔旁可见一球形软组织密度影,周边可见新月形气体影;B.右肺下叶多发囊状透亮影及厚壁空洞,空洞内可见团片状略低密度影,呈“海蚌含珠征”,右肺下叶支气管扩张,右侧胸膜局部增厚; C.左上肺尖后段结节影,可见孤立厚壁空洞,空洞内软组织密度影; D.左肺下叶背段结节影,边缘见新月形气体影(气体新月征),周围可见斑片影(晕轮征)

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出版历程
  • 收稿日期:  2014-05-10
  • 刊出日期:  2014-07-30

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