摘要
目的:研究慢性空洞性肺病的临床特点,探讨外科手术对慢性空洞性肺病的疗效。方法:回顾性分析2017年6月至2024年6月西安市胸科医院收治的163例胸外科住院慢性空洞性肺病患者的临床资料,对治疗结果进行统计分析。结果:163例患者中,空洞性肺结核86例,空洞性肺真菌病45例,空洞性肺结核合并真菌感染32例。其中,咯血患者116例(71.2%),结核分枝杆菌痰菌阳性59例(36.2%);经过手术治疗后,咯血患者均不再咯血,痰菌阴转患者56例(阴转率为94.9%),因胸腔感染死亡1例。116例咯血患者中,结核性空洞51例,真菌性空洞38例,结核合并真菌性空洞27例;51例结核性空洞患者中,6例因术中大出血中转开胸,38例真菌性空洞患者中,1例因术中大出血中转开胸,27例结核合并真菌性空洞患者中,2例因术中大出血中转开胸。除2例支气管胸膜瘘患者、1例因胸腔感染死亡患者和3例痰菌未阴转患者外,其余患者均取得良好手术效果。结论:对于手术指征明确的慢性空洞性肺病患者,在使用抗菌药物至少6个月后,择期手术治疗能有效解决咯血和排菌问题;并且可以缩短慢性空洞性肺病患者的病程,明显提高患者的生活质量。
Objective:To understand the clinical characteristics of chronic cavitary lung disease,and to explore the effect of surgery on it.Methods:Clinical data of 163 patients with chronic cavitary lung disease hospitalized in Thoracic Surgery Department of Xi’an Chest Hospital from June 2017 to June 2024 were retrospectively analyzed.Results:Among the 163 cases,there were 86 cases of cavitary pulmonary tuberculosis,45 cases of cavitary pulmonary mycosis,and 32 cases of cavitary pulmonary tuberculosis complicated with fungal infection.Among them,116 cases(71.2%)got hemoptysis,and 59 cases(36.2%)were sputum-positive for Mycobacterium tuberculosis.After operation,all hemoptysis cases stopped hemoptysis symptom,56 cases had sputum conversion(negative-conversion rate was 94.9%),one case died of chest infection.Among the 116 hemoptysis cases,51 cases had tuberculous cavities,38 cases had fungal cavities,and 27 cases had tuberculosis combined with fungal cavities.Among the 51,38 and 27 cases,6,1 and 2 cases were converted to thoracotomy due to intraoperative massive hemorrhage,respectively.Except for 2 cases with bronchopleural fistula and 1 case with chest infection were dead,3 cases didn’t get their sputum converted to negative,all other patients had achieved good surgical results.Conclusion:For patients with chronic cavitary lung disease with clear surgical indications,elective surgical treatment can effectively solve hemoptysis and bacterial discharge problems after using antibiotics for at least 6 months;And it can shorten the course of chronic cavitary lung disease patients and significantly improve their quality of life.
作者
任航空
孙伟峰
汪林宝
Ren Hangkong;Sun Weifeng;Wang Linbao(Department of Thoracic Surgery,Xi’an Chest Hospital,Xi’an 710061,China)
出处
《中国防痨杂志》
北大核心
2025年第9期1180-1186,共7页
Chinese Journal of Antituberculosis
基金
西安市卫生和计划生育委员会卫生科研人才培训项目(J201902023)。
关键词
肺疾病
真菌性
结核
肺
肺外科手术
胸腔镜检查
治疗结果
Lung diseases,fungal
Tuberculosis,pulmonary
Pulmonary surgical procedures
Thoracoscopy
Treatment outcome
