CAJ | 학술논문

目的探讨肺曲菌球病的诊断及治疗,减少手术的并发症.方法回顾性分析2005年4月至2012年5月行手术治疗的24例肺曲菌球病患者的临床资料.男18例,女6例;年龄22 ～ 67岁.其中行肺叶切除15例,全肺切除4例,复合切除(肺叶+肺楔形切除)3例,右肺上、中叶切除1例,病灶清除+脓腔引流1例.结果无手术死亡病例,全部患者均治愈,7例发生并发症,包括术中大量渗血1例,术后大出血1例,肺部感染2例,支气管胸膜瘘1例,肺复张不全1例,切口感染1例,其中2例行二次开胸手术治疗并发症.术后随访均无咯血或血痰、复发或死亡.结论手术切除是肺曲菌球病的首选治疗方法,随着外科手术技术的提高及胸腔镜技术的应用,同时加强围手术期的处理,将最大限度地降低肺曲菌球病手术的并发症发生率.
목적 탐토폐곡균구병적진단급치료,감소수술적병발증.방법 회고성분석2005년4월지2012년5월행수술치료적24례폐곡균구병환자적림상자료.남18례,녀6례;년령22 ～ 67세.기중행폐협절제15례,전폐절제4례,복합절제(폐협+폐설형절제)3례,우폐상、중협절제1례,병조청제+농강인류1례.결과 무수술사망병례,전부환자균치유,7례발생병발증,포괄술중대량삼혈1례,술후대출혈1례,폐부감염2례,지기관흉막루1례,폐복장불전1례,절구감염1례,기중2례행이차개흉수술치료병발증.술후수방균무각혈혹혈담、복발혹사망.결론 수술절제시폐곡균구병적수선치료방법,수착외과수술기술적제고급흉강경기술적응용,동시가강위수술기적처리,장최대한도지강저폐곡균구병수술적병발증발생솔.
Objective To improve the diagnosis and surgical management of pulmonary aspergilloma.Methods Twenty-four patients underwent surgical treatment for pulmonary aspergilloma were enrolled in our study from April 2005 to May 2012 at the second hospital of Xiamen.The information of all cases was recorded.Results There were 18 males and 6 females in all subjects,and their age ranged from 22 to 67 year.The surgical outcome were 15 lobectomies,3 segmentectomies or wedge resections,1 right upper and middle lobectomy,1 radical debridement,4 pneumonectomy.Results There was no preoperative mortality.Seven cases (29.2％) developed complications in this series including 1 postoperative bleeding,1 bleeding during operation,2 pulmonary infection,1 bronchial fistula,1 pulmonary reexpansion insufficiency,1 wound infection.Conclusion Surgical resection of pulmonary lesion is the most effective method for pulmonary aspergilloma.Moreover strengthening the perioperative management could decrease the morbidity and mortality.