支气管镜介入治疗肺毛霉病伴主支气管闭塞1例  

Bronchoscopic intervention therapy for pulmonary mucormycosis with main bronchial occlusion:acasereport

作　　者：吴秀秀 王娟[1] 金艳坤 林隆[1] 邱小建[1] 张杰[1] 王婷[1] Wu Xiuxiu;Wang Juan;Jin Yankun;Lin Long;Qiu Xiaojian;Zhang Jie;Wang Ting(Department of Respiratory and Critical Care Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院呼吸与危重症医学科,北京100070

出　　处：《中华结核和呼吸杂志》2024年第6期550-553,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：北京市医管局科研培育计划(PX2021022)。

摘　　要：肺部毛霉感染是毛霉病中最常见的感染类型之一,其中气管支气管肺毛霉病以累及气管支气管树为主要表现,病变可侵及气道黏膜、肌层,进而破坏软骨,具有发病急、进展快、病死率高等特点,临床治疗具有挑战性。本文报道1例肺毛霉感染并发左主支气管闭塞患者的诊治过程,在以两性霉素B静脉注射联合泊沙康唑口服混悬液为主的全身治疗基础上,患者先后经历了多次支气管镜下介入治疗,包括镜下局部灌注两性霉素B、球囊扩张以及硅酮支架置入等,经过4个月的综合治疗,疗效满意。本文旨在阐明支气管镜介入治疗在肺毛霉病综合治疗过程中具有重要作用,特别是可以避免因阻塞性肺炎进展导致的死亡。Pulmonary mucormycosis is one of the most common types of mucormycosis.Tracheobronchial pulmonary mucormycosis primarily affects the tracheobronchial tree,causing lesions that can invade the airway mucosa and muscular layer,damaging the cartilage.It is characterised by acute onset,rapid progression,and high mortality rate,making clinical treatment challenging.This article reports the diagnosis and treatment of a patient with pulmonary mucormycosis complicated by left main bronchus occlusion.In addition to systemic treatment,which consisted mainly of an intravenous injection of amphotericin B combined with an oral suspension of posaconazole,the patient underwent multiple bronchoscopic interventions,including local infusion of amphotericin B under endoscopy,balloon dilation and silicone stent placement.After four months of comprehensive treatment,the therapeutic effect was satisfactory.This report demonstrates that bronchoscopic intervention therapy plays an important role in the comprehensive treatment of pulmonary mucormycosis,especially in preventing death from the progression to obstructive pneumonia.

关 键 词：阻塞性肺炎 主支气管 感染类型 泊沙康唑 肺毛霉病 气管支气管 支气管镜 两性霉素B 

分 类 号：R563[医药卫生—呼吸系统]