CAJ | 학술논문

目的探讨肺结核合并肺曲菌球病手术适应证的选择及通过术后并发症的分析,评价其外科治疗效果.方法回顾性分析北京胸科医院自1993-2010年收治肺结核合并肺曲菌病手术患者51例,突出症状为咯血,有咯血史者40例(78.4％,40/51).51例手术患者中,采用单纯肺叶切除31例(60.8％,31/51),肺段切除8例(15.7％,8/51),肺楔形切除5例(9.8％,5/51),全肺切除5例(9.8％,5/51),复合肺叶切除2例切除(3.9％,3/51).结果术后并发症13例,占25.5％,其中术后肺不张并肺炎4例(7.8％),支气管胸膜瘘3例(5.9％),术后活动性胸腔出血4例(7.8％),心律失常并心衰1例(2.0％),切口感染1例(2.0％),围手术期无死亡.结论肺结核合并肺曲菌球病的外科治疗是其首选方法,术前客观的检查评价是减少手术并发症的关键.
목적 탐토폐결핵합병폐곡균구병수술괄응증적선택급통과술후병발증적분석,평개기외과치료효과.방법 회고성분석북경흉과의원자1993-2010년수치폐결핵합병폐곡균병수술환자51례,돌출증상위각혈,유각혈사자40례(78.4％,40/51).51례수술환자중,채용단순폐협절제31례(60.8％,31/51),폐단절제8례(15.7％,8/51),폐설형절제5례(9.8％,5/51),전폐절제5례(9.8％,5/51),복합폐협절제2례절제(3.9％,3/51).결과 술후병발증13례,점25.5％,기중술후폐불장병폐염4례(7.8％),지기관흉막루3례(5.9％),술후활동성흉강출혈4례(7.8％),심률실상병심쇠1례(2.0％),절구감염1례(2.0％),위수술기무사망.결론 폐결핵합병폐곡균구병적외과치료시기수선방법,술전객관적검사평개시감소수술병발증적관건.
Objective To investigate the surgical indications of pulmonary tuberculosis complicated with aspergilloma,and to reduce postoperative complications.Methods From 1993 to 2010,a total of 51surgically treated patients in pulmonary tuberculosis complicated with aspergilloma were analyzed retrospectively.The common surgical procedure performed was lobectomy (60.8％),followed by segmentectomy (15.7％),pneumonectomy (9.8％),wedge resection (9.8 ％).Result Postoperative nonfatal complications occurred in all patients,the complications (13 cases)included postoperativeatelectasis (7.8 ％),bleeding (5.9 ％),bronchopleural fistula (5.9％),cardiacarrhythmia and heart failure (2.0％),incisional infection (2.0％).Conclusion Surgical treatment of pulmonary tuberculosis complicated with aspergilloma is the most effective treatment; pulmonary resection is the treatment of choice when indicated.