肺曲霉菌病的诊治及误诊原因分析

The Diagnosis and Treatment of Pulmonary Aspergilloma and Its Cause of Misdiagnosis

目的 总结肺曲霉菌的诊治经验及误诊原因。方法:回顾性分析1978-10～2001-06外科手术治疗43例肺曲霉菌病的临床资料,总结肺曲霉菌病的诊治经验及误诊原因。结果:本组43例中6例无原发病,有原发病37例。术前误诊17例,误诊率39.5％(17/43),误诊时间为6个月到84个月。全组病例无手术死亡。随访2～24a,无肺曲霉菌复发。结论:临床医师对本病的认识不足是误诊的主要原因,提高对本病的认识程度,熟悉其影像学特征是减少误诊的关键,外科手术治疗行病变肺叶切除是根治本病的有效手段。

Objective:To summarize the experience in diagnosis and treatment of pulmonary aspergilloma and to analyze the cause of misdiagnosis. Methods:Clinical datas from 43 patients treated surgically from October 1978 to June 2001 were analyzed restrospectively. and the experience of diagnosis and treatment and the cause of misdiagnosis were reviewed. Results;Of all 43 cases, 6 had no primary affection, and 37 had . 17cases were misdiagnosed preoperatively. (39. 5% ,17/43). All cases were survival. No relapse was found after 2 years' follow-up. Conclusion;The lack of knowledge of pulmonary aspergilloma was the main cause for misdiagnosis. It could be avoided by improve awareness of pulmonary aspergilloma and by analysis of imaging . Pulmonary lobectomy was the effective way to eradicate the illness.