摘要
目的探讨经纤维支气管镜(纤支镜)诊断治疗肺曲菌球的方法及治疗效果。方法对38例肺曲菌球采用经纤支镜钳夹活检确定诊断,经镜下清除曲菌球、全身及局部使用抗真菌药物等治疗方法进行治疗,部分大咯血病例在纤支镜治疗前先予支气管动脉双重栓塞治疗咯血,对上述病例的治疗效果进行追踪观察。结果38例肺曲菌球病例均得到病理诊断,30例肺曲菌球全部清除干净的病例,咯血症状完全消失,X线及胸部CT示肺部病灶明显减少或消失,追踪观察2～45个月,肺曲菌球病情无复发,肺内无曲菌球再生长,X线及胸部CT复查肺部病灶无变化;8例因各种原因未能彻底清除肺曲菌球的病例则出现咳嗽、咯血症状再发。结论经纤支镜可早期确诊肺曲菌球,并能对多数病例进行彻底清除,该治疗方法可行,损伤小,疗效确切,可作为除手术之外肺曲菌球的另一有效治疗方法。
Objective: To explore the diagnostic and therapeutic methods of pulmonary aspergilloma via fiberoptic bronchoscopy and the efficacy of the treatment. Methods: In 38 cases with pulmonary aspergilloma, diagnosis were made via fiberoptic bronchoscopy biopsy; aspergillomas were cleaned via perbronchial fiberoptic bronchoscope, local and general antifungal therapy were made; part of cases with massive hemoptysis received the embolization of bronchial artery (BAE). The efficacy was observed. Results: In 30 cases, the pulmonary aspergillomas were removed absolutely,symptom such as hemoptysis disappeared wholly, radiography and chest CT showed that the focuses in lung reduced distinctly or disappeared. After 2~45 months following up,symptoms didn′t recur, no aspergillomas reproduced in lung,reexamination of X-ray had no difference; in 8 cases,the pulmonary aspergillomas weren′t removed absolutely for some kinds of reason, the symptoms such as hemoptysis and cough recurred. Conclusion: The pulmonary aspergilloma could be confirmed a diagnosis early via fiberoptic bronchoscopy, in most cases, the aspergilloma could be removed absolutely. The therapeutic methods are feasible, with small damage and definite curative effect. It could be a new kind of effective method in treatment of pulmonary aspergilloma in addition to the operative treatment.
出处
《中国内镜杂志》
CSCD
2004年第11期35-38,共4页
China Journal of Endoscopy
关键词
肺
曲菌球
纤维支气管镜
诊断
治疗
lung
aspergilloma
fiberoptic bronchoscopy
diagnosis
treatment
