肺结核合并曲霉菌感染的诊断和外科治疗

摘要 目的：探讨肺结核合并曲霉菌感染的诊断和外科治疗。方法：对我科2008年1月—2010年12月收治的38例肺结核合并曲霉菌感染患者的临床资料进行分析总结。结果：38例患者均获手术切除病灶。术后病理证实均为肺结核合并肺曲菌感染，其基础疾病包括结核性空洞17例，结核性肺毁损12例，结核性支气管扩张症9例；18例术前已明确合并有曲霉菌感染，占47.4%；术前漏诊20例，漏诊率为52.6%；术后再发痰中带血1例，并发症发生率2.6%，本组无死亡病例，术后随访1-3年未再发曲霉菌感染。结论：肺结核合并曲霉菌感染漏诊率高；手术切除病灶是治疗肺结核合并曲菌感染最有效的方法。

关键词 肺结核、曲霉菌感染、外科手术

The diagnosis and surgical treatment of Pulmonary Tuberculosis complicated with Aspergillus infection

【Abstract】Objective: To sdudy the diagnosis and surgical treatment of Pulmonary Tuberculosis complicated with Aspergillus infection. Methods: Analysis the clinical data of 38 patients who suffering from Pulmonary Tuberculosis complicated with Aspergillus infection treated in our department from January 2008 to December 2010. Results:38 patients obtained operation excision of the lesion. The postoperative pathology confirmed Pulmonary Tuberculosis with Aspergillosis infection, of which，17 cases with tuberculosis cavity, 12 cases with tuberculousis destroyed lung, 9 cases with Tuberculous bronchiectasis; 18 cases in the preoperative has been clearly complicated with Aspergillus infection, accounting for 47.4%;20 cases were missed diagnosis before operation, the missed diagnosis rate was 52.6%; 1 cases recurred hemoptysis in the postoperative, the complication rate was 2.6%, with no deaths in this group, the patients were followed-up for 1 to 3 years without recurrence of Aspergillus infection. Conclusion: Misdiagnosis rate of Pulmonary Tuberculosis combined Aspergillus infection is high；Operation excision of the lesion is an effective treatment way of the Pulmonary Tuberculosis complicated by Aspergillosisinfection.

【Key words】 Pulmonary tuberculosis, Aspergillus infection, Surgical operation