慢性空洞性肺曲霉病患者13例手术治疗经验总结

Summary of Surgical Treatment Experience of 13 Patients with Chronic Cavitary Pulmonary Aspergillosis

目的:总结慢性空洞性肺曲霉病(CCPA)患者的临床特点、手术治疗及治疗效果,为临床决策提供参考。方法:选取2019年4月—2021年3月临沧市人民医院心胸外科手术治疗的CCPA患者,回顾性分析患者的临床表现、合并疾病、手术方式、术后效果。结果:所有患者临床表现为咯血或痰中带血,开胸或电视辅助胸腔镜下肺叶切除或联合肺楔形切除术为主要手术方式,对患者进行临床治疗,13例术后患者咯血消失,2例术后轻度胸痛,不影响工作生活,后期无须治疗。结论:手术治疗CCPA疗效满意,预后良好,但手术风险高,术中出血是主要并发症。临床工作中应综合患者整体情况综合分析,制定个体化手术治疗方案,使患者获益最大化。

Objective:To summarize the clinical characteristics,surgical treatment and therapeutic effects of patients with chronic cavitary pulmonary aspergillosis(CCPA),and provide reference for clinical decision-making.Methods:Patients with CCPA who were treated by Department of Cardiothoracic Surgery in Lincang People's Hospital from April 2019 to March 2021 were selected for retrospective analysis of their clinical manifestations,combined diseases,surgical methods and postoperative effects.Results:The clinical manifestations of all patients were hemoptysis or blood in sputum,and the main surgical methods were thoracotomy or video-assisted thoracoscopic lobectomy or combined pulmonary wedge resection;After clinical treatment,13 patients disappeared after hemoptysis,and 2 patients had mild chest pain after surgery,which did not affect their work and life and did not require treat⁃ment in the later stage.Conclusion:Surgical treatment of CCPA has satisfactory curative effect and good prognosis,but the opera⁃tive risk is high,and intraoperative bleeding is the main complication.In clinical work,the overall situation of patients should be comprehensively analyzed and individualized surgical treatment plan should be formulated to maximize the benefit of patients.