局限性肺毛霉菌病的外科治疗  

Surgical treatment of isolated pulmonary mucormycosis

作　　者：朱伟鹏 杨帆[1] 曹加顺 侯贤明 周婷[1] 张子木 陈东红 Zhu Weipeng;Yang Fan;Cao Jiashun;Hou Xianming;Zhou Ting;Zhang Zimu;Chen Donghong(Department of Thoracic Surgery,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院、清华大学临床医学院胸外科,北京102218

出　　处：《中华胸心血管外科杂志》2024年第10期612-617,共6页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的回顾性分析局限性肺毛霉菌病的外科治疗, 探讨其手术时机及效果。方法收集2019年4月至2024年4月行手术治疗的局限性肺毛霉菌病患者临床资料, 对其进行回顾性分析, 并结合文献复习。结果共收集行手术治疗的肺毛霉菌病患者临床资料13例, 其中男9例, 女4例, 患者年龄22~64岁, 平均(45.4±15.4)岁。基础疾病包括糖尿病10例、血液系统恶性肿瘤3例。7例患者在病程中出现咯血。术前13例患者均行充分的抗真菌药物治疗, 12例行支气管镜下介入治疗。所有患者均为局限性肺毛霉菌病, 单肺叶切除10例, 全肺切除2例, 袖状右全肺切除1例。除1例术后出现支气管胸膜瘘外, 其余患者均临床治愈。所有患者均实现了毛霉菌的完全清除及抗真菌药物的停用。结论对于局限性肺毛霉菌病, 在系统性抗真菌药物治疗的基础上, 积极寻求手术介入的时机, 能够缩短病程, 改善预后。Objective:To retrospectively analyze the surgical treatment of isolated pulmonary mucormycosis,explore the timing and effect of operation.Methods:Clinical data of patients with isolated pulmonary mucormycosis who underwent surgical treatment from April 2019 to April 2024 were collected and retrospectively analyzed,combined with literature review.Results:The clinical data of 13 patients with pulmonary mucormycosis who underwent operation were collected,including 9 males and 4 females,aged 22~64(45.4±15.4)years old.The basic diseases included diabetes mellitus in 10 cases and hematological malignancy in 3 cases.Seven patients had hemoptysis during the course of the disease.All 13 patients received adequate antifungal therapy before surgery,and 12 patients received bronchoscopic interventional therapy.Ten patients underwent lobectomy,two underwent pneumonectomy,and one underwent a right sleeve pneumonectomy.All patients were cured except one patient with bronchopleural fistula after operation.All patients achieved complete elimination of mucor and also discontinuation of antifungal drug.Conclusion:For isolated pulmonary mucormycosis,on the basis of systemic antifungal treatment,actively seek the opportunity of surgical intervention,can shorten the course of the disease and achieve good therapeutic results.

关 键 词：毛霉菌病 肺切除术 手术治疗 

分 类 号：R655.3[医药卫生—外科学]