儿童侵袭性肺部曲霉菌及毛霉菌病外科治疗指征的探讨  

Exploration of surgical treatment indications for invasive pulmonary aspergillosis and mucormycosis in children

作　　者：刘鼎义 曾骐 陈诚豪 张娜[1] 于洁[1] 严冬 徐长琪 张谦[1] 张旭[1] Liu Dingyi;Zeng Qi;Chen Chenghao;Zhang Na;Yu Jie;Yan Dong;Xu Changqi;Zhang Qian;Zhang Xu(Department of Thoracic Surgery,Beijing Children's Hospital,Capital Medical University,National Clinical Research Center for Respiratory Disease,Key Laboratory of Major Diseases in Children,Ministry of Education,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家呼吸系统疾病临床医学研究中心、儿科重大疾病研究教育部重点实验室、国家儿童医学中心、首都医科大学附属北京儿童医院胸外科,北京100045

出　　处：《中华胸心血管外科杂志》2024年第2期85-88,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：北京市医院管理中心儿科学科协同发展中心儿科专项(XTZD20180105)。

摘　　要：目的回顾分析侵袭性肺部曲霉菌及毛霉菌病患儿的临床资料,探讨该病的手术指征。方法回顾性分析北京儿童医院胸外科2018年3月至2022年11月共10例侵袭性肺部曲霉菌及毛霉菌病患儿的临床资料。结果男6例,女4例,年龄2.58~16.00岁。侵袭性肺部曲霉菌病5例,侵袭性肺部毛霉菌病5例。手术指征为气道内大出血风险7例,控制感染继续治疗恶性肿瘤2例,长期抗真菌药物治疗后感染迁延不愈但病灶局限1例。2例因手术前突发急性咯血死亡,8例行手术治疗的患儿预后良好。结论侵袭性肺部曲霉菌及毛霉菌病的致死率极高,抗真菌药物治疗结合及时的手术治疗可以挽救患儿的生命。Objective To review and analyze clinical data of patients with invasive pulmonary aspergillosis and mucormycosis,and to explore the surgical indication.Methods Clinical data of 10 patients with invasive pulmonary aspergillosis and mucormycosis were analyzed retrospectively from March 2018 to November 2022 in our hospital,Department of Thoracic Surgery.Results The age of children varied from 2.58 years old to 16.00 years old and 6 children were males while 4 females.Five patients suffer from invasive pulmonary aspergillosis.Five patients suffer from invasive pulmonary mucormycosis.The operative indication of 7 patients was the risk of massive bleeding in the airway.The surgical indication for two patients is to control infection and continue treating malignant tumors.One patient chose surgical treatment because the infection could not be cured after long-term antifungal treatment but the focus was limited.Two patients died of sudden acute hemoptysis before operation,the prognosis of 8 patients undergoing surgical treatment was good.Conclusion The lethal rate of invasive pulmonary aspergillosis and mucormycosis is very high.Antifungal drug treatment combined with timely surgical treatment can save patients lives.

关 键 词：侵袭性肺部曲霉菌病 侵袭性肺部毛霉菌病 手术指征 

分 类 号：R725.6[医药卫生—儿科]