摘要
目的:探讨肺结节病的临床特点及影响其治疗和预后的因素。方法:对肺结节病患者46例进行随访15~75个月,分析其临床资料。结果:46例肺结节病患者中Ⅰ期17例,Ⅱ期25例,Ⅳ期4例;其中咳嗽、胸闷、胸痛为最常见症状,65%患者有肺外受累,支气管镜下联合活检病理阳性率为89%。27例症状明显或有重要器官受累者均使用了糖皮质激素治疗,19例单纯观察。所有患者均临床稳定或好转,用药者病变有吸收的比例高于单纯观察者。结论:肺结节病患者症状无特异性,经支气管镜联合活检诊断价值高,对是否治疗要基于患者症状、肺功能、影像和进展情况综合考虑,尚无适用所有患者的标准化管理策略,需个体化治疗,长期监测。
Objective:To explore the clinical characteristics of pulmonary sarcoidosis and the factors that affected its treatment and prognosis.Methods:46 patients with pulmonary sarcoidosis were followed up for 15~75 months to analyze their clinical data.Results:There were 17 cases in stageⅠ,25 cases in stageⅡand 4 cases in stageⅣ.Cough,chest tightness and chest pain were the most common symptoms,65%cases had extrapulmonary involvement,the pathological positive rate of combined biopsy under bronchoscopy was 89%.Glucocorticoids were used in 27 cases with obvious symptoms or significant organ involvement and 19 cases were simply observed.All patients achieved clinical stability or improvement,the proportion of lung lesions absorbed in the treatment group was higher than that in the observation group.Conclusion:The symptoms of pulmonary sarcoidosis are non-specific and the diagnostic value of bronchoscopy combined biopsy is high,whether the treatment should be done based on the patient's symptoms,lung function,CT imaging and progress of comprehensive consideration,there is no standardized management strategy for all patients,so it needs individualized treatment with long-term monitoring.
作者
李亚珍
穆雪鹍
傅应云
Li Yazhen;Mu Xuekun;Fu Yingyun(The Second Clinical College of Jinan University,Department of Respiratory and Critical Care Medicine of Shenzhen People's Hospital,Respiratory Diseases Institute of Shenzhen City,Guangdong Shenzhen 518020)
出处
《中国社区医师》
2020年第34期12-13,共2页
Chinese Community Doctors
基金
深圳市科技创新计划项目(JCYJ20160422142121988)。
关键词
肺结节病
诊断
治疗
预后
Pulmonary sarcoidosis
Diagnosis
Treatment
Prognosis