肺结核并发肺曲菌球47例外科治疗

The surgical treatment of 47 pulmonary tuberculosis patients with aspergrilloma

目的探讨肺曲菌球与肺结核的关系及其诊断和治疗;方法对13年经外科手术治疗的47例肺结核合并曲菌球病人进行回顾性分析;结果男性31例,占66.0%,病程>5年27例。咯血症状突出,41例,占87.2%。47例肺结核合并曲菌球中,术前明确诊断32例,占68.1%,漏误诊率31.8%。45例治愈,占95.7%,死亡2例,占4.2%。术后并发症10例,分别为胸腔感染、支气管胸膜瘘、肺炎、肺不张、支气管哮喘、呼吸衰竭和失血性休克。结论肺曲菌球病见于肺结核空洞患者,在长期规律抗结核治疗后仍反复咯血,漏诊率较高,手术治疗为首选,效果较好。

Object To probe into the relation,diagnosis and treatment of the pulmonary aspergilloma and tuberculosis. Method The data of surgical treatment of 47 pulmonary tuberculosis patients with aspergrilloma were analysed retrospectly. Results 31cases(65.1%) were male patients; 28 cases with more than 5 years histories; 41 cases(87.2% )with serious hemoptysis. Among 47 pulmonary tuberculosis patients with aspergrilloma, 32 cases (68.1%) had confirmed diagnosis before operation. The rate of missed diagnosis is 31.8%. 45 cases( 95.7%)were cured. Two cases(4.2%) died.10 cases have complication of chest infection, pneumonia, bronchi and pleura fistula, pulmonary atelectama, bronchial asthma, respiratory failure, hemorrhagic shock. ConclusionThe pulmonary aspergilloma occurs in the patients with tuberculosis cavitation. The patients still had repeatedly hemoptysis after regular anti?tuberculosis treatment. The rate of missed diagnosis is high. Operation is the best and effective treatment.