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目的:探讨肺结核空洞继发曲菌感染的特点,提高该病的诊治水平。方法:回顾性分析2008年1月～2009年12月在广州市胸科医院内科住院的79例经病理确诊的肺结核空洞继发曲菌感染的临床资料。结果:79例患者中从最初诊断肺结核至诊断空洞内曲菌感染的平均时间为9.3年;咯血72例(91.1%):最初被误诊为肺结核复发21例(26.6%);19例(24.0%)外科行病灶侧全肺或病灶所在肺叶切除术治疗:53例(67.1%)患者行纤支镜空洞内曲菌球清除术。结论:对于存在长期不能闭合肺结核空洞且反复咯血的患者应警惕空洞内继发曲菌感染,及时诊断,根据病人不同情况选择适当的治疗方法,预后良好。
Objective: To investigate the characteristics of secondary fungal infection of pulmonary tuberculosis and to improve the diagnosis and treatment of the disease. Methods: The clinical data of 79 pathologically confirmed pulmonary tuberculosis secondary to Aspergillus infections were retrospectively analyzed from January 2008 to December 2009 in Guangzhou Chest Hospital. Results: The average time from the initial diagnosis of pulmonary tuberculosis to the diagnosis of aspergillosis in 79 patients was 9.3 years. In 72 cases (91.1%) of hemoptysis, it was initially misdiagnosed as pulmonary tuberculosis recurrence in 21 cases (26.6%) and in 19 cases (24.0% ) Surgical treatment of lung lobectomy with focal lung or lesion: 53 patients (67.1%) underwent fungal endoscopy with fungoscopy. CONCLUSIONS: Patients with long-term pulmonary tuberculosis can not be closed and repeated hemoptysis should be vigilant secondary to germ infection in the cavity, timely diagnosis, according to the patient’s condition, select the appropriate treatment, the prognosis is good.