CAJ | 학술논문

目的探讨减少肺结核合并肺真菌病的发生和误诊.方法以肺结核病情好转或稳定中出现新的症状,X线、CT片显示新病灶或原病灶扩大,痰真菌培养连续3次生长同种真菌且抗真菌治疗后病情改善,痰真菌培养无原真菌生长为标准.48例患者被确诊合并肺真菌病并做回顾性分析.结果本组患者肺结核病灶范围较广泛,空洞多,痰菌阳性率高(32/48),多有高热、血白细胞[(15～35)×109/L]和中性粒细胞计数较高,及广谱抗生素和糖皮质激素使用史,多误诊.结论本病易误诊,临床应予重视,规则使用广谱抗生素和激素可减少其发生率.
목적 탐토감소폐결핵합병폐진균병적발생화오진.방법 이폐결핵병정호전혹은정중출현신적증상,X선、CT편현시신병조혹원병조확대,담진균배양련속3차생장동충진균차항진균치료후병정개선,담진균배양무원진균생장위표준.48례환자피학진합병폐진균병병주회고성분석.결과본조환자폐결핵병조범위교엄범,공동다,담균양성솔고(32/48),다유고열、혈백세포[(15～35)×109/L]화중성립세포계수교고,급엄보항생소화당피질격소사용사,다오진.결론본병역오진,림상응여중시,규칙사용엄보항생소화격소가감소기발생솔.
Objective To discuss decreasing occurrence and misdiagnosis of pulmonary tuberculosis with pulmonary fungus. Methods Forty-eight cases were diagnosed pulmonary fungus based on the patients presented fever, cough or primary symptom exaggerated.X-ray and CT examining showed new lesions or primary lesions enlarged. Same fungus grew on the culture for three times continuously. After antimycosis treatment, the patients condition got well, symptom dismissed, fungus didn't grow on the culture of the sputum.The above material were studied retrospectively. Results Their sphere of lesions of pulmonary tuberculosis were large. There were many cavities, high positive rate of mycobacteria(32/48), high fever cough, expectoration, leukocytosis[(15-35)×109/L)]and used antibacterial corticoid drugs in these patients. Most of them were misdiagnosed. Conclusions Fungus are misdiagnosed easily and must be paid attention. It should be decreased for using regular antibacterial corticoid drugs.