中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2011年
1期
26-29
,共4页
王钰琦%孙玉鹗%初向阳%戴为民%杨博%赵明
王鈺琦%孫玉鶚%初嚮暘%戴為民%楊博%趙明
왕옥기%손옥악%초향양%대위민%양박%조명
肺疾病,真菌性%胸外科手术%活组织检查
肺疾病,真菌性%胸外科手術%活組織檢查
폐질병,진균성%흉외과수술%활조직검사
Lung diseases,fungal%Thoracic surgical procedures%Biopsy
目的 总结51例肺真菌病患者的临床特点、诊断和外科治疗经验.方法 回顾分析1981-2008年解放军总医院胸外科收治的51例肺真菌病患者的临床资料.结果 本组肺真菌病患者包括白念珠菌3例,曲霉菌22例,隐球菌26例.其临床症状包括咳嗽、咯血、发热、胸闷、胸痛和哮喘,但有20例为常规体格检查发现病灶.胸部X线片和CT检查中,29例表现为肺内实质性结节,部分有毛刺、棘突;13例表现为肺空洞,壁厚均一,内壁较光滑,其中7例见曲菌球.行标准剖胸手术48例,行胸腔镜或胸腔镜辅助小切口手术3例;肺叶切除17例,局部楔形切除34例.本组病例无手术死亡,且均经术后病理证实,随访3~10年无复发.结论 原发性肺真菌病的临床表现和影像学检查缺乏特征性表现,病理检查为确诊依据,手术是诊断及治疗本病的一种较有效的方法.
目的 總結51例肺真菌病患者的臨床特點、診斷和外科治療經驗.方法 迴顧分析1981-2008年解放軍總醫院胸外科收治的51例肺真菌病患者的臨床資料.結果 本組肺真菌病患者包括白唸珠菌3例,麯黴菌22例,隱毬菌26例.其臨床癥狀包括咳嗽、咯血、髮熱、胸悶、胸痛和哮喘,但有20例為常規體格檢查髮現病竈.胸部X線片和CT檢查中,29例錶現為肺內實質性結節,部分有毛刺、棘突;13例錶現為肺空洞,壁厚均一,內壁較光滑,其中7例見麯菌毬.行標準剖胸手術48例,行胸腔鏡或胸腔鏡輔助小切口手術3例;肺葉切除17例,跼部楔形切除34例.本組病例無手術死亡,且均經術後病理證實,隨訪3~10年無複髮.結論 原髮性肺真菌病的臨床錶現和影像學檢查缺乏特徵性錶現,病理檢查為確診依據,手術是診斷及治療本病的一種較有效的方法.
목적 총결51례폐진균병환자적림상특점、진단화외과치료경험.방법 회고분석1981-2008년해방군총의원흉외과수치적51례폐진균병환자적림상자료.결과 본조폐진균병환자포괄백념주균3례,곡매균22례,은구균26례.기림상증상포괄해수、각혈、발열、흉민、흉통화효천,단유20례위상규체격검사발현병조.흉부X선편화CT검사중,29례표현위폐내실질성결절,부분유모자、극돌;13례표현위폐공동,벽후균일,내벽교광활,기중7례견곡균구.행표준부흉수술48례,행흉강경혹흉강경보조소절구수술3례;폐협절제17례,국부설형절제34례.본조병례무수술사망,차균경술후병리증실,수방3~10년무복발.결론 원발성폐진균병적림상표현화영상학검사결핍특정성표현,병리검사위학진의거,수술시진단급치료본병적일충교유효적방법.
Objective To summarize the clinical characteristics, diagnosis and surgical management experiences of 51 cases of pulmonary fungal infections. Methods The clinical data of 51pulmonary fungal infection patients hospitalized in department of thoracic surgery of PLA General Hospital from 1981 to 2008 were retrospectively analyzed. Results The recruited cases included three cases of Candida albicans, 22 of Aspergillus, and 26 of Cryptococcus. The clinical symptoms included cough, hemoptysis, fever, chest tightness, chest pain and asthma. Twenty cases were identified through routine healthy examination. Of chest X-ray and computed tomograply scan, 29 cases presented with solid nodules in the lung, some of which had burrs and spikes; 13 presented with pulmonary cavity with even wall thickness and smooth inner wall including 7 with aspergillar glomera.Forty-eight cases underwent standard thoracotomy operations and 3 cases underwent thoracoscope or thoracoscopy-assisted minithoracotomy. Seventeen underwent pulmonary lobectomies, and 34 wedge resections. There was no operative mortality in the 51 patients. All diagnoses were confirmed by postoperative pathology. There was no relapse during 3- 10 years of follow-up. Conclusions Primary pulmonary fungal infections lack characteristic presentations in clinical manifestations and imaging examinations. Pathology is the evidence for definite diagnosis. Surgical intervention is an effective tool for diagnose and treatment of this disease.