国内肺隐球菌病临床资料汇总分析

A Combined Analysis of the Domestic Literature Data of Pulmonary Cryptococcosis

目的了解国内报道的肺隐球菌病的流行病学特征、临床及影像学特点、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。方法检索1980～2007年中国医院数字图书馆CHKD期刊全文库收录的有关肺隐球菌病的文献,统计分析221例肺隐球菌病患者的临床资料。结果肺隐球菌病好发于青中年男性,其临床表现及影像学表现呈多样性和无特异性,易并发隐球菌性脑膜炎(24.0%),临床上极易误诊;确诊主要依靠各种临床标本的涂片、培养和病理学检查;治疗手段主要包括手术切除和抗真菌药物的治疗。结论临床上提高对该病的认识是提高确诊率的关键。强调抗真菌药物的治疗作用,尤其是术前、术后应用,可减少隐球菌播散导致隐球菌性脑膜炎。

Objective To explore the epidemiological, clinical and imaging features, diagnosis and misdiagnosis, the treatment and prognosis of Pulmonary cryptococcosis so as to provide important clues for doctors to made quick and accurate diagnosis. Methods Document retrieval of the literature about Pulmonary cryptococcosis in CHKD from 1980 to 2007, the clinical data of 221 cases with Pulmonary cryptococcosis were summarized and statistically analyzed. Results Pulmonary cryptococcosis mainly invaded the male young adults, its clinical and imaging manifestations were diverse and non - specific and often led to the complication of cryptococcal meningitis （ 240. % ） ; it was often misdiagnosed in clinic ; the final diagnosis depended on the smears, culturing and pathological examination of various clinical specimen; the main treatments were surgical resection and pharmacotherapy with anti-fungi drugs. Conclusions To raise the cognition to Pulmonary cryptececcosis is the key to the increase of final diagnosis rate; the administration of anti - fungi drugs before and after operation should be stressed, which may reduce the occurrence of cryptececcal meningitis caused by the dissemination of Cryptecoccus.