肺隐球酵母菌病临床分析  

Clinical analysis of pulmonary cryptococcosis

作　　者：徐冰凌[1] 余金泉 刘大钺[3] 唐可京[1] 谢灿茂[1] 

机构地区：[1]中山大学附属第一医院呼吸内科 [2]医院感染管理科,广东广州510080 [3]香港大学深圳医院内科,广东深圳518053

出　　处：《中华医院感染学杂志》2015年第5期1076-1078,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划基金资助项目(2008A030201029)

摘　　要：目的：探讨肺隐球酵母菌病的临床特点、治疗和预后，提高临床对本病的认识，以提高治愈率。方法回顾性分析1999年11月－2012年11月在医院经病理确诊的42例肺隐球酵母菌病患者临床资料。结果42例肺隐球酵母菌病患者中27例患者有临床症状，主要表现为咳嗽、咳痰、胸闷、胸痛和发热；胸部C T主要表现为肺部单发或多发结节影、肿块影或实变影，病灶主要累及下肺；全部病例均给予了治疗，其中手术病灶切除18例，6例术后给予氟康唑治疗1-3个月；另外24例给予抗真菌药物治疗；所有患者除1例手术切除后未予抗真菌治疗在术后2个月出现复发外，其余病例均无复发、播散或死亡。结论肺隐球酵母菌病患者若能够早期诊断并给予合适的治疗，绝大部分患者预后良好。OBJECTIVE To explore the clinical characteristics ,treatment ,and prognosis of pulmonary cryptococco‐sis and improve the awareness of the disease so as to raise the cure rate .METHODS The clinical data of 42 patients who were pathologically confirmed as pulmonary cryptococcosis from Nov 1999 to Nov 2012 were retrospectively analyzed .RESULTS Of the 42 cases of pulmonary cryptococcosis ,27 had the clinical symptoms ,including the cough ,expectoration ,chest tightness ,chest pain ,and fever .The single or multiple pulmonary nodules ,masses or consolidation shadows ,and lower lobes mainly involved lesions were the major chest CT scan findings .All the cases were given the therapy ,18 cases underwent the focal resection surgery ,6 cases were treated with fluconazole for 1‐3 months after surgery ,and the rest of 24 cases were given the antifungal agents therapy .After the surgery for two months ,there was no case of recurrence ,dissemination ,or death except for 1 case of reoccurrence who underwent the resection and were not given the antifungal agents therapy .CONCLUSION Most of the patients with pulmonary cryptococcosis have good prognosis if they are diagnosed in early stage and receive appropriate therapy .

关 键 词：肺隐球酵母菌病 临床表现 诊断 治疗 

分 类 号：R181.32[医药卫生—流行病学]