慢性空洞型肺曲霉病围手术期抗真菌药物治疗病例分析  

Clinical Analysis of Perioperative Antifungal Therapy for Chronic Cavitary Pulmonary Aspergillosis Patients

作　　者：余尔茜 郑旭勇 杨娟娟[1] 张春红[1] 张秀华[1] Yu Erqian;Zheng Xuyong;Yang Juanjuan;Zhang Chunhong;Zhang Xiuhua(The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第一医院,浙江温州325000

出　　处：《药物流行病学杂志》2019年第1期18-22,共5页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:对真实的临床病例进行分析,探讨慢性空洞型肺曲霉病(CCPA)围手术期使用抗真菌药物的必要性,为临床治疗提供重要参考。方法:回顾性收集某三甲医院确诊为CCPA并在2011年5月1日～2018年6月30日接受手术患者的病历资料,其中8例围手术期使用抗真菌药物,定义为用药组(A组),26例未使用抗真菌药物,定义为未用药组(B组)。对两组患者术后的临床症状改善情况、血常规变化、并发症发病率、复发率和死亡率进行比较分析。结果:两组患者术前基本情况差异无统计学意义(P> 0. 05),但B组患者肺功能好于A组(P <0. 05)。术后咯血症状均较术前改善(A组:P <0. 05,B组:P <0. 01);两组间临床症状改善情况及血常规变化比较无差异(P> 0. 05),两组最终结局(并发症发病率、复发率、死亡率)的差异无统计学意义(P> 0. 05)。结论:慢性空洞型肺曲霉病患者围手术期间使用抗真菌药物获益不明显。Objective: To investigate the necessity of perioperative antifungal therapy for patients with chronic cavitary pulmonary aspergillosis( CCPA) according to the real clinical cases,and provide a reference for clinical treatment.Methods: A retrospective study of 34 CCPA patients who underwent operation between May 1,2011 and June 30,2018 was performed. 8 patients received antifungal therapy after the surgery,defined as group A. 26 patients were treated with surgery alone without antifungal therapy( group B). The improvement of clinical symptoms,blood routine,complications rate,recurrence rate and mortality were compared between the two groups. Results: There was no significant difference in preoperative condition from baseline of group A and B( P > 0. 05). But the pulmonary fuction of group B were better than the group A( P < 0. 05). The symptom of hemoptysis was improved after surgery in both groups( Group A: P < 0. 05,Group B: P < 0. 01). While the improvement of clinical symptoms and blood routine were undifferentiated( P > 0. 05). The outcomes( complications rate,morbidity,mortality) between the two groups had not significant differences( P > 0. 05). Conclusion: Perioperative antifungal therapy had little benefit for patientis with CCPA.

关 键 词：慢性空洞型肺曲霉病 手术治疗 抗真菌药物 回顾性分析 

分 类 号：R978.5[医药卫生—药品]