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目的探讨肺曲霉菌病的临床特征、影像学特点、诊断和治疗方法,提高对该病的认识。方法回顾性分析2003—2013年昆山市第一人民医院收治的肺曲霉菌病患者58例的临床资料。结果 58例患者中,仅28例初步诊断考虑有肺曲霉菌感染,19例误诊为肺癌或肺结核;26例经手术治疗,32例为内科保守治疗;53例治疗后好转,5例患者死亡。结论肺曲霉菌病诊断困难,且常需与支气管哮喘、支气管扩张、肺结核及肺癌等疾病相鉴别。肺曲霉菌球经手术切除及抗真菌药物治疗后预后较好;变应性支气管肺曲霉菌病需长期激素联合抗真菌治疗;而侵袭性肺曲霉菌病病死率较高,预后较差。
Objective To investigate the clinical characteristics, imaging features, diagnosis and treatment of pulmonary aspergillosis and to improve its understanding of the disease. Methods The clinical data of 58 patients with pulmonary aspergillosis who were treated in Kunshan First People’s Hospital from 2003 to 2013 were retrospectively analyzed. Results Of the 58 patients, only 28 cases were diagnosed as pulmonary aspergillosis initially, 19 cases were misdiagnosed as lung cancer or pulmonary tuberculosis, 26 cases were treated by surgery, 32 cases were treated conservatively, 53 cases improved after treatment and 5 patients died. Conclusion Pulmonary aspergillosis is difficult to diagnose and often needs to be differentiated from other diseases such as bronchial asthma, bronchiectasis, pulmonary tuberculosis and lung cancer. Pulmonary Aspergillus ball after surgery and antifungal therapy better prognosis; allergic bronchial pulmonary aspergillosis need long-term hormone combined antifungal therapy; and aggressive pulmonary aspergillosis mortality is high, the prognosis is poor.