肺结核后空洞内继发曲菌球两种治疗方法的比较研究  

Comparison of two methods in treatment of aspergilloma inside cavities of pulmonary tuberculosis

作　　者：郑闽莉[1,2] 汤春梅[1] 肖海浩[1] 刘伟光[1] 方琼[1] 谢艺开[1] 张言斌[1] 

机构地区：[1]广州市胸科医院,广州510095 [2]广州医学院,广州510182

出　　处：《中国防痨杂志》2011年第7期412-415,共4页Chinese Journal of Antituberculosis

基　　金：广东省医学科学基金资助(编号:A2005584)

摘　　要：目的比较研究经支气管镜介入清除和手术切除肺结核后空洞内继发曲菌球的临床价值。方法回顾分析183例肺结核后空洞内继发曲菌球感染患者住院治疗时间、治疗费用、治疗并发症及治疗效果。结果 183例患者,126例接受经支气管镜介入清除治疗,57例接受手术切除治疗,平均住院时间分别为49 d和46 d,平均治疗费用分别为26 535元和50 296元,手术切除治疗的并发症发生率较高且程度较重,但手术切除治疗彻底、复发率较低。结论对肺结核后空洞内继发曲菌球患者,经支气管镜介入清除治疗可以得到较彻底有效的治疗效果,并发症少且轻微,治疗费用较手术明显减少,在手术风险大、肺功能储备少或不愿接受手术较大损伤的患者,支气管镜介入清除治疗可以作为一种较好的选择。Objective To compare clinical value of bronchofibroscope excision and surgical resection in treatment of aspergilloma inside cavities of pulmonary tuberculosis.Methods One hundred and eighty three hospitalized cases with aspergilloma inside cavities of pulmonary tuberculosis were analyzed retrospectively on time of therapy,treatment costs,complication of therapy and efficacy.Results Of 183 cases,126 cases received excision of aspergilloma by bronchoscope and 57 cases received surgical resection.Average time of therapy were 49 days and 46 days using bronchofibroscope excision and surgical resection,respectively.Average treatment costs were 26 535 yuan and 50 296 yuan,respectively.Incidence rate of complications using surgical resection was higher than that of bronchofibroscope excision.But surgical resection was complete and low rate of relapse.Conclusion Bronchofibroscope excision can get relatively thorough,efficacy,less complication and low costs in patients with aspergilloma inside cavities of pulmonary tuberculosis.It is a better method in patients who are poor pulmonary function reserve,high surgical risk and reluctant to accept surgery.

关 键 词：结核 肺/并发症 曲霉菌病 肺疾病 真菌性 支气管镜检查 

分 类 号：R521[医药卫生—内科学]