肺放线菌病临床特点及诊断研究

发布时间：2018-04-05 00:14

本文选题：肺放线菌病　切入点：临床表现　出处：《中华医院感染学杂志》2014年14期

【摘要】：目的探讨肺放线菌病临床特点、影像学表现及诊断,从而提高临床医师对该病的诊治水平。方法检索1995-2013年18年中国知网收录的肺放线菌病历,选取资料较完整的48例,以及确诊的肺放线菌病2例,共50例,分析其临床资料。结果肺放线菌病发病以男性多见,好发年龄40~50岁;50.0%病程2个月;大多数患者有吸烟史,共35例占70.0%;常见的临床表现咳嗽、咳痰、咯血、发热、胸痛及呼吸困难,分别占96.0%、92.0%、64.0%、40.0%、34.0%及22.0%;最易误诊为肺癌,共28例占56.0%,其次为肺炎11例占22.0%;胸部影像学特点:病变多位于左肺下叶16例占32.0%,16例累及多个肺叶,19例累及多个肺段、1例累及胸壁软组织及肋骨;23例影像学示胸膜增厚;患者分别通过经皮肺穿刺活检14例,占28.0%、电子气管镜活检11例,占22.0%及术后病理活检22例,占44.0%,找到放线菌明确诊断。结论肺放线菌病的临床表现无特异,容易误诊,好发于吸烟、有肺部基础疾病者,最易误诊为肺癌和肺炎,对于临床疑诊为肺癌,虽经多次支气管镜检查仍无法明确诊断,应警惕肺放线菌病的可能。
[Abstract]:Objective to investigate the clinical features, imaging manifestations and diagnosis of pulmonary actinomycosis.Methods A total of 50 cases of pulmonary actinomycosis collected from 1995 to 2013 were analyzed in 48 cases of pulmonary actinomycosis and 2 cases of pulmonary actinomycosis.Results the incidence of pulmonary actinomycosis was more common in men, the predilection age was 40 years old or 50 years old or 50.0% of the disease course was 2 months, most of the patients had smoking history (35 cases accounted for 70.0%), the common clinical manifestations were cough, expectoration, hemoptysis, fever, chest pain and dyspnea.They account for 34.0% and 22.0%, respectively, of 92.0% and 64.0%, respectively, and are most likely to be misdiagnosed as lung cancer.There were 28 cases (56.0), followed by 11 cases (22.0) pneumonia, chest imaging features: 16 cases were located in the left lower lobe of lung, 16 cases were involved in multiple lobes and 16 cases involved multiple lobes, 19 cases involved multiple segments of lung, 1 case involved chest wall soft tissue and 23 cases showed pleural thickening.There were 14 cases (28.0%) by percutaneous lung biopsy, 11 cases (22.0%) by electronic tracheoscopy biopsy and 22 cases (44.0%) by pathological biopsy after operation. A definite diagnosis of actinomycetes was found.Conclusion the clinical manifestation of pulmonary actinomycosis is nonspecific and easy to misdiagnose. It is easy to be misdiagnosed as lung cancer and pneumonia in patients with basic diseases of lung and smoking.The possibility of pulmonary actinomycosis should be warned.
【作者单位】：首都医科大学附属北京世纪坛医院呼吸与危重症学科;
【基金】：北京市卫生系统高层次卫生技术人才基金资助项目(2013-2-014)
【分类号】：R519.1

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