肺曲菌球的外科治疗（附182例报告）

目的探讨肺曲菌球的手术适应证及手术治疗效果。方法回顾性分析我院1975年9月至2008年1月经手术治疗的182例肺曲菌球患者资料，分为单纯性肺曲菌球组（SPA，n：42）和复合性肺曲菌球组（CPA，n；140）。行肺叶切除术146例，全肺切除13例，复合切除（肺叶＋肺段或楔形切除）11例，肺段切除7例，楔形切除5例。结果182例患者中治愈178例，治愈率97．8％。无手术死亡，术后发生并发症47例（25．8％），包括出血5例，持续漏气10例，肺炎11例，肺复张不全8例，支气管胸膜瘘、脓胸3例，心律失常3例，肺脓肿5例，切口感染2例。SPA组术后并发症发生率低于CPA组（P〈0．05）。术后随访173例，随访4个月～5年无复发。结论外科手术为肺曲菌球的首选治疗方法。对于病程短、肺病变局限、胸膜粘连较轻的患者电视胸腔镜具有创伤小、恢复快、术后并发症少的优点是其最佳选择。

Surgical treatment of pulmonary aspergilloma:a report of 182 cases

Objective To investigate the surgical indications of pulmonary aspergilloma,and to reduce postoperative complications.MethodsA total of 182 surgically treated patients with pulmonary aspergilloma were analyzed retrospectively from September 1975 to January 2008.All patients were divided into two groups:simple pulmonary aspergilloma(SPA,n:42)and complex pulmonary aspergilloma(CPA,n:140),according to the nature and extent of the underlying lung disease.The operative procedures included 146 pulmonary lobectomy...