肺结核合并肺曲菌球病的外科治疗  

Surgical treatment of pulmomary tuberculosis complicated with aspergilloma

作　　者：阮军忠[1] 张天辉[1] 段勇[1] 王子彤[1] 

机构地区：[1]首都医科大学附属北京胸科医院胸外科,101149

出　　处：《中华医学杂志》2013年第25期1975-1977,共3页National Medical Journal of China

摘　　要：目的 探讨肺结核合并肺曲菌球病手术适应证的选择及通过术后并发症的分析,评价其外科治疗效果.方法 回顾性分析北京胸科医院自1993-2010年收治肺结核合并肺曲菌病手术患者51例,突出症状为咯血,有咯血史者40例（78.4％,40/51）.51例手术患者中,采用单纯肺叶切除31例（60.8％,31/51）,肺段切除8例（15.7％,8/51）,肺楔形切除5例（9.8％,5/51）,全肺切除5例（9.8％,5/51）,复合肺叶切除2例切除（3.9％,3/51）.结果 术后并发症13例,占25.5％,其中术后肺不张并肺炎4例（7.8％）,支气管胸膜瘘3例（5.9％）,术后活动性胸腔出血4例（7.8％）,心律失常并心衰1例（2.0％）,切口感染1例（2.0％）,围手术期无死亡.结论 肺结核合并肺曲菌球病的外科治疗是其首选方法,术前客观的检查评价是减少手术并发症的关键.Objective To investigate the surgical indications of pulmonary tuberculosis complicated with aspergilloma,and to reduce postoperative complications.Methods From 1993 to 2010,a total of 51surgically treated patients in pulmonary tuberculosis complicated with aspergilloma were analyzed retrospectively.The common surgical procedure performed was lobectomy （60.8%）,followed by segmentectomy （15.7%）,pneumonectomy （9.8%）,wedge resection （9.8 %）.Result Postoperative nonfatal complications occurred in all patients,the complications （13 cases）included postoperativeatelectasis （7.8 %）,bleeding （5.9 %）,bronchopleural fistula （5.9%）,cardiacarrhythmia and heart failure （2.0%）,incisional infection （2.0%）.Conclusion Surgical treatment of pulmonary tuberculosis complicated with aspergilloma is the most effective treatment; pulmonary resection is the treatment of choice when indicated.

关 键 词：结核 肺 肺曲菌病 外科手术 

分 类 号：R655.3[医药卫生—外科学]