经纤维支气管镜治疗继发性肺曲霉肿的临床研究

目的 研究经纤维支气管镜(纤支镜)治疗继发性肺曲霉肿的临床应用价值。方法观察比较43例经纤支镜治疗和30例经手术切除治疗的继发性肺曲霉肿的治疗效果及术后并发症。结果43例经纤支镜治疗的继发性肺曲霉肿患者中有35例的肺曲霉肿得到彻底地治疗，症状、体征明显改善，追踪观察2～50个月病情无复发。8例因各种原因未得到彻底治疗的病例则出现咳嗽、咯血反复，该组病例纤支镜治疗后未出现明显的并发症。30例经手术切除治疗的继发性肺曲霉肿患者的肺曲霉肿均得到彻底治疗．但手术并发症高达66．7％，其中1例死亡．4例需再次手术治疗。结论病变广泛、粘连严重、累及支气管的肺结核空洞内的继发性曲霉肿，经纤支镜治疗可能是最好的选择，对于纤支镜难以到达的较边缘的肺曲霉肿或同-肺叶内多个曲霉肿，应选择手术治疗。

Clinical Study of the Application of Fiberoptic Bronchoscope in the Treatment of Patient with Secondary Pulmonary Aspergilloma

Objective To study the clinical application of the fiberoptic bronchoscope in the t reatment of patient with secondary pulmonary aspergilloma.Method The efficacy and complications afte r therapy of the fiberoptic bronchoscopy treatment of 43cases with secondary pulmonary aspergillo ma were compared with 30cases treate d with thoracic surgical procedures.Results In 43cases with secondary pulmonary aspergilloma received fiberoptic b ronchoscopy treatment,35cases had a complete re moval of pulmonary aspergilloma with improved symptoms and showed no com plication after a 2to 50months follow up.The other 8cases due to some reasons the pul monary aspergillum has not been comp letely removed and showed some symptoms such as hemoptysis and recurred coughin g.In 30cases with secondary pulmonary aspergilloma received the thoracic surgical treatment,the pulmonary a spergilloma were completely removed,but 66.7%showed postoperative complication s and in which 1case was dead and 4case s needed reoperetion.Conclusions The fiberoptic bronchoscopy treatment may be the best treatment for secondary pulmonary aspergilloma growing i n the cavity of lung tuberculosis with extensive fo cus and adhesion and implicated bron chial tuberculosis,while the thora cic surgical procedures were suitable for secondary pulmonary aspergilloma growing in the edge of lung where the fiberopt ic bronchoscope can not reach or with several aspergillomas in a labe of the lung.