肺放线菌病支气管镜下表现特征及分型  

Study on bronchoscopic features and classification of pulmonary actinomycosis

作　　者：张光照[1] 杜佳辉[1] 袁五营[1] 于海峰 李坤营 梁瑞霞[3] Guang-zhao Zhang;Jia-hui Du;Wu-ying Yuan;Hai-feng Yu;Kun-ying Li;Rui-xia Liang(Department of Minimally Invasive Surgery,Henan Provincial Chest Hospital,Zhengzhou,Henan 450003,China;Department of Endoscopy Center,Henan Provincial Chest Hospital,Zhengzhou,Henan 450003,China;Department of Tuberculosis,Henan Provincial Chest Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南省胸科医院微创外科,河南郑州450003 [2]河南省胸科医院内镜中心,河南郑州450003 [3]河南省胸科医院结核科,河南郑州450003

出　　处：《中国内镜杂志》2021年第6期79-87,共9页China Journal of Endoscopy

摘　　要：目的探讨肺放线菌病的临床特点、支气管镜下表现特征及分型,以提高对该病的认识和诊疗水平。方法回顾性分析该中心经病理确诊为肺放线菌病的65例患者的临床病史、影像特征、支气管镜下表现和治疗方法等。结果该病常见主诉为咯血和咳嗽,影像学表现缺乏特异性;支气管镜下可表现为乳白色脓液、坏死、新生物、异物或结石钙化侵蚀感染、非特异性充血、水肿等,通过支气管镜或其他形式的病理活检可确诊。结论肺放线菌病极易被误诊,支气管镜下可表现为隐匿表现型、化脓坏死型、腔内肿物型、机化侵蚀型和混合表现型。积极抗生素治疗或手术治疗后治愈率较高。Objective To explore the clinical features,bronchoscopic features and classification of pulmonary actinomycosis,in order to improve the understanding of the disease,the level of diagnosis and treatment.Methods The clinical history,imaging features,bronchoscopic manifestations and treatment methods of 65 patients with pathologically confirmed pulmonary actinomycosis in this center were retrospectively analyzed.Results The common chief complaints were hemoptysis and cough,and the imaging manifestations were lack of specificity;Bronchoscopy can show milky white pus,necrosis,new organisms,foreign bodies or stones calcification erosion infection,non-specific congestion,edema,etc,bronchoscopy or other forms of pathological biopsy can be diagnosed.Conclusion Pulmonary actinomycosis is easy to be misdiagnosed;Under bronchoscopy,there were latent phenotype,suppurative necrosis type,intraluminal mass type,organic erosion type and mixed phenotype.The cure rate was high after active antibiotic treatment or surgical treatment.

关 键 词：肺放线菌病 支气管镜表现 分型 肉芽肿性炎 误诊 

分 类 号：R519.1[医药卫生—内科学]