12例确诊肺曲霉菌病临床分析

发布时间：2018-06-28 19:26

本文选题：肺部感染 + 真菌　；参考：《中华医院感染学杂志》2013年02期

【摘要】：目的通过对12例确诊肺曲霉菌病患者的临床特征、宿主因素、CT特点、诊断及治疗的回顾性分析,以提高早期诊断和治疗水平。方法采用回顾性研究,查阅2004年1月-2011年9月新疆医科大学第一附属医院病历资料,收集肺曲霉菌病确诊病历相关资料,制作调查表格。结果 12例患者中侵袭性肺曲霉病2例,均有宿主因素,临床特征以发热、呼吸急促为主,胸部CT主要表现为结节、实变、斑片及空洞影,1例出现新月征,1例支气管镜下取痰曲霉菌属培养阳性,1例肺组织病理检查阳性,1例抗真菌治疗有效,1例死亡;寄生性肺曲霉菌病10例,8例有肺部基础疾病,临床症状以咯血多见,胸部CT表现结节8例,团块、空洞、斑片各2例,晕轮征、新月征各1例;9例行手术治疗,其中6例在术前未被考虑肺曲霉菌病;术后电话随访7例,治愈6例。结论肺曲霉菌病临床特征不典型,痰检阳性率低,早期不易诊断,另外部分患者因病情危重不能耐受手术或气管镜检查;其早期诊断方法有待进一步探讨。
[Abstract]:Objective to improve the early diagnosis and treatment of pulmonary aspergillosis by retrospective analysis of clinical features, host factor CT features, diagnosis and treatment of 12 patients with pulmonary aspergillosis. Methods retrospective study was used to review the medical records of the first affiliated Hospital of Xinjiang Medical University from January 2004 to September 2011. The relevant data of the confirmed cases of pulmonary aspergillosis were collected and the investigation forms were made. Results two of 12 patients with invasive pulmonary aspergillosis had host factors. The clinical features were fever and shortness of breath. Crescent sign in 1 case and crescent sign in 1 case, sputum aspergillus culture positive in 1 case, pulmonary histopathology in 1 case, antifungal therapy in 1 case, parasitic pulmonary aspergillosis in 10 cases, pulmonary basic disease in 8 cases, The clinical symptoms were hemoptysis in 8 cases, mass in 8 cases, cavity in 2 cases, plaque in 2 cases, halo sign in 2 cases, crescent sign in 1 case and crescent sign in 9 cases, in which 6 cases were not considered pulmonary aspergillosis before operation, 7 cases were followed up by telephone after operation. 6 cases were cured. Conclusion the clinical features of pulmonary aspergillosis are atypical, the positive rate of sputum examination is low, and the early diagnosis is difficult to diagnose.
【作者单位】：新疆医科大学第一附属医院呼吸二科;新疆医科大学第一附属医院病理科;新疆医科大学第一附属医院影像中心;
【分类号】：R519

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