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国内20年肺曲霉菌病临床资料汇总分析 被引量:11

Domestic gather of analysis on clinical data of pulmonary aspergillosis in recent 20 years
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摘要 目的了解20年来国内报道的肺曲霉菌病的流行病学特征、临床特点、影像学特点、确诊方法、误诊情况、治疗及预后,为临床医师快速准确地诊断本病提供重要线索。方法回顾性分析1988~2007年国内有关肺曲霉菌感染的文献资料,统计分析并总结了293例肺曲霉菌病患者的临床资料。结果293例患者中肺曲霉球型181例(61.8%),侵袭性肺曲霉菌病107例(36.5%),变应性支气管肺曲霉菌病5例(1.7%)。肺曲霉菌病好发于有肺部基础疾病及其他基础疾病的患者,男、女比例2:1;其临床表现无特异性,而影像学表现呈多样性,临床易误诊,误诊率为74.6%;确诊主要靠呼吸道分泌物涂片、培养以及病理学检查;治疗手段包括手术切除和抗真菌药物的应用。结论肺曲霉菌病的临床表现缺乏特异性,极易导致误诊,给临床诊断带来困难,必须加深对其认识。 Objective To know the epidemiology, clinical and imageology characteristic, diagnosis, misdiagnosis, treatment and prognosis of pulmonary aspergillosis reported in China,in an attempt to provide important clues for prompt and accurate diagnosis. Methods Retrospective analysis includes 27 pieces of reporters from 1988 to 2007 in China and the clinical data of 293 patients with pulmonary aspergillosis are summarized. Results There are 181 cases (61.8%) with pulmonary aspergillosis ball,107 cases (36.5%) with invasive pulmonary aspergillosis and 5 cases (1.7%) with allergic bronchopulmonary aspergillosis in 293 cases of patients. Pulmonary aspergillosis occurred in the patients who have chronic pulmonary diseases or other chronic diseases. The males are more than the females in a ratio of 2 : 1. The clinical manifestations of pulmonary aspergillosis have no specificity and the imageology manifestation is in variety, so its clinical misdiagnosis rate reaches up to 74.6 %. Its final diagnosis mainly depends on smear, cultivation of respiratory tract secretion and pathologic test of the lung. Therapeutic tool involved resection with operation and the application of anti-fungi drugs. Conclusions The diversity of clinical manifestations in pulmonary aspergillosis have resulted in higher clinical misdiagnosis rate. It is hoped that this article can provide some valuable clues for the clinicians.
出处 《国际呼吸杂志》 2009年第4期193-196,共4页 International Journal of Respiration
关键词 曲霉菌病 侵袭性 感染 治疗 Lung Aspergillosis Invasive Infection Therapy
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