肺曲霉病患者42例临床分析

<正>曲霉菌属于真菌,广泛分布于自然界中,在健康人群中亦是如此,多于机体抵抗力下降时发病,目前已发现的曲霉菌超过200多种,而致病菌多是烟曲霉菌。在临床工作中,肺曲霉病多继发于肺结核、支气管扩张症、肺气肿、免疫力低下或恶性肿瘤化疗的

Analysis of 42 Cases of Pulmonary Aspergillosis

Objective: To investigate the clinical and imaging findings of patients with pulmonary aspergillosis and to analyze the effects of different treatments of internal and external surgery on patients with pulmonary aspergillosis. Methods: Forty-two inpatients diagnosed as pulmonary aspergillosis by pathology or culture in our hospital from June 2013 to June 2018 were enrolled. The clinical manifestations, imaging, diagnosis and treatment were analyzed. Results: Of the 42 patients, 25 patients underwent surgical resection, 4 patients had hemoptysis after operation, 2 patients improved after interventional therapy, and 2 patients improved after drug treatment. The other patients recovered well after surgery without recurrence. There were 17 non-surgical patients and 1 died, and the rest were improved after conservative + interventional therapy. Among the main symptoms, 29 patients (69.0%) had hemoptysis, 19 of whom had no further hemoptysis after intervention (65.5%), and 2 patients had a history of repeated interventions, all of whom were unsurgical. There were other lung diseases in this group, including 36 cases (85.7%) with tuberculosis, 18 cases (42.9%) with bronchiectasis, 4 cases (9.5%) with pulmonary infection, and 2 cases (4.8%) with emphysema. There were different types of imaging findings, including 13 cases (30.9%) with new moon, 22 cases (52.4%) with cavities, and 5 cases (11.9%) with nodular nodules. Except for 1 case of bronchial pleural effusion, the other patients recovered better, and there were more hemoptysis in non-surgical group. Conclusion: Pulmonary aspergillosis is often complicated with other lung diseases, and the clinical symptoms are lack of specificity. The imaging findings are not specific to the crescent shape. It is better to choose a treatment according to different conditions of the patient. Can be promoted as one of the hemoptysis treatment methods.