国内22年肺隐球菌病回顾性分析

目的　回顾国内 2 2年来肺隐球菌病的诊疗进展。方法　检索 1980～ 2 0 0 1年中文生物医学期刊数据库 (CMCC)收录的有关肺隐球菌病的文献资料 ,统计分析并总结 6 7例肺隐球菌病患者的临床资料。结果　肺隐球菌病好发于青中年男性 ,其临床表现及影像学表现呈多样性和无特异性 ,易并发隐球菌性脑膜炎 (31 34% ) ,临床上极易误诊 ;确诊主要依靠各种临床标本的涂片、培养和病理学检查 ;治疗手段主要包括手术切除和抗真菌药物的治疗。结论　临床上提高对该病的认识是提高确诊率的关键。强调抗真菌药物的治疗作用 ,尤其是术前术后应用 ,可减少术后隐球菌的播散导致隐球菌性脑膜炎。

Domestic retrospective analysis of pulmonary cryptococcosis in the recent 22 years

Objective To learn the domestic investigation into pulmonary cryptococcosis in the 22 years.Methods We retrieved the literature about pulmonary cryptococcosis included in CMCC,and summarized the clinical data of 67 patients suffering from pulmonary cryptococcosis.Results The clinical situation and radiological manifestation of pulmonary cryptococcosis were diverse and nonspecific.Cryptococcal meningitis was the commonest complication(31.34%).Almost all patients with pulmonary cryptococcosis were once misdiagnosed.Final diagnosis mainly depended on the smear,culture or pathological examination of various clinical specimens.Therapeutic tool involved resection with operation and the application of anti-fungi drugs.Conclusion To increase the cognition to the disease is the key to increase the final diagnosis rate.Therapeutical effect of anti-fungi drugs should be emphasized,especially the application in preoperation and postoperation can decrease the dissemination of cryptococcus after operation,which might result in cryptococcal meningitis.