肺放线菌病15例临床分析

Clinical analysis of 15 cases of actionamycosis

目的探讨肺放线菌的临床特点,提高临床医师对本病的认识。方法回顾性分析河南省胸科医院2005年9月至2013年9月确诊的15例肺放线菌病病例。结果 115例患者中男性10例,女性5例;年龄18~68岁;病程7d^2年。215例患者中15例均有咳嗽、咳痰,其中咳黄脓痰者3例,1例伴有胸闷。发热7例,最高体温达39.5℃。咯血14例,多为痰中带血。3例合并有糖尿病,1例CT诊断为支气管扩张。315例患者中通过纤支镜确诊5例,1例靠肺穿刺诊断,12例经手术病理证实。415例均使用抗生素治疗,全部好转出院。结论肺放线菌病临床少见,易误诊为结核和肿瘤,应引起临床医师重视,早期诊断,尽可能减少手术治疗。

Objective To study the clinical features of actinomycosis and to increase the understanding of it. Methods To review the clinical date of 15 cases of actinomycosis retrospectively in Henan Province Chest Hospital from September 2005 to September 2013. Results ①50 patients including 10 male and 5 female, with age ranging from 18 to 68 year old（ mean age 53.3 years old） were studied and they suffered from the disease for a mean period of 7 days -2years. ② The symptoms included cough （15 cases） , including 3 cases of yellow purulent sputum, 1 case was accompanied by chest distress, hemoptysis （14 cases） blood in phlegm and febrile （7 cases）, the highest temperature of 39. 5 ℃ of 3 patients with diabetes, 1 ease of CT diagnosis of bronchieetasis. Radiologieal thoracic actinomysis was nonspecifie. ③ The diagnosis was made with pulmonary lobectomy in 12 cases, biopsy with bronchoseope in 5 cases. CT guided by fine needle aspiration in 1 case. ④All the 15 patients accepted Appropriate therapy of antibiotics and the treatment was effective in all. Conclusion Primary bronehopulmonary actinomycosis is a rare infectious disease. It easily misdiagnosed as tuberculosis and lung cancer, clinical physicians should paid attention, early diagnosis to minimized unnecessary surgery.