肺结核合并肺曲霉菌感染的临床病理学分析

Clinical Pathology Analysis of Pulmonary Tuberculosis Complicated with Aspergillosis Infection

目的探讨分析肺结核合并肺曲霉菌感染的临床病理学情况。方法随机选取该院自2012年10月—2014年10月收治的50例肺结核合并肺曲霉菌感染患者用于临床研究,回顾性分析这50例患者的临床资料,对其临床病理学情况进行分析。结果存在陈旧性肺结核病史的占40%,痰涂片发现抗酸杆菌阳性的占30%,左上肺空洞型肺结核的占50%,两肺散在支气管扩张伴感染的占40%,两上肺和左下肺背段出现多发斑片状高密度影和纤维条索影的占30%,上皮样肉芽肿形成的占40%,灶状凝固性坏死的占50%,脓肿和彻底的凝固性坏死的占10%。结论肺曲霉菌感染是肺结核的常见并发症,其临床诊断应当结合病理学检查、影像学检查、痰涂片检查及细菌培养检查等多种检查方法,其中,病理学检查更具权威性,值得广大相关医护人员在临床上大力推广与应用。

Objective To study and analyze the pathological analysis of pulmonary tuberculosis complicated with aspergillo-sis infection. Methods 50 patients with pulmonary tuberculosis complicated with aspergillosis infection who were admitted to this hospital from October 2012 to October 2014 were included in this clinical analysis. Their clinical data was retro-spectively analyzed. Their clinicopathological feature was analyzed. Results 40% patients were found with old lung tubercu-losis for a long time. Smear of sputum for acidfast bacillus was positive in 30% of patients. 50% patients were found with cavitary pulmonary tuberculosis in upper left lung. Bronchiectasis complicated with infections which scattered in two lungs was found in 40% of patients. Patchy and high-density shadow, and fiber shadow located in two upper lungs and dorsal segment of left lower was found in 30%of patients. Epithelioid granulomas can be observed in 40%of patients. Focal coag-ulation necrosis can be found in 50% of patients. Abscess and complete coagulation necrosis was found in 10% of patients. Conclusion Pulmonary aspergillus infection is a common complication of pulmonary tuberculosis and its clinical diagnosis should be combined with many kinds of inspection methods, including pathological examination, imaging studies, sputum smear and germiculture examination. Among them, the more authoritative pathology examination is worthy of popularization and application by relevant medical personnel in their clinical practice.