肺结核空洞继发曲菌感染79例临床分析

目的:探讨肺结核空洞继发曲菌感染的特点,提高该病的诊治水平.方法:回顾性分析2008年1月～2009年12月在广州市胸科医院内科住院的79例经病理确诊的肺结核空洞继发曲菌感染的临床资料.结果:79例患者中从最初诊断肺结核至诊断空洞内曲菌感染的平均时间为9.3年;咯血72例(91.1%);最初被误诊为肺结核复发21例(26.6%);19例(24.0%)PF科行病灶侧全肺或病灶所在肺叶切除术治疗;53例(67.1%)患者行纤支镜空洞内曲菌球清除术.结论:对于存在长期不能闭合肺结核空洞且反复咯血的患者应警惕空洞内继发曲菌感染,及时诊断,根据病人不同情况选择适当的治疗方法,预后良好.

Clinical Analysis of 79 Patients with Cavernous Pulmonary Tuberculosis Complicated by Aspergilloma

Objective： To investigate characteristic of cavernous pulmonary tuberculosis eomplicated by aspergilloma and to improve the diagnosis and treatment of the disease. Methods： The clinical data of 79 cases got a pathology confirmed secondary pulmonary aspergilloma were analyzed retrospectively from Jan 2008 to Dec 2009. Results： The average time from diagnose cavernous pulmonary tuberculosis complicated by aspergilloma was 9.3 years, spite blood in 72 cases（91.1%）, misdiagnosed by pulmonary tuberculosis re-occurred in 21 cases（26.6%）. 19 （24.0%） cases treated by operative procedures （one lateral of lung and lobe of lung） and 53 cases（67.1%） treated by fiberoptic bronchoscopy. Conclusion： We should warn the secondary pulmonary aspergilloma with the cases suffered from pulmonary cavity for a long time and spite blood repeated , diagnose it at first time and choose the suitable therapy method according to the different condition of patient, the predict will be well if we do as the above method.