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目的探讨肺曲菌病的诊断治疗情况,提高对肺曲菌病的认识。方法回顾分析2012年1月—2014年1月本院收治的51例肺曲菌患者的临床资料,统计分析患者临床表现、影像学表现、实验室检查结果及治疗方案。结果肺曲菌病合并肺结核27例,咳嗽、咳痰症状32例,发热21例,胸闷19例;胸部影像学以双肺弥漫性病变为主29例;18例查见曲霉菌;47例患者应用伏立康唑序贯治疗,其中41例临床症状好转。结论肺曲菌病合并肺结核较常见,临床症状不典型,诊断困难时建议尽早行肺穿刺,应用伏立康唑序贯治疗疗效满意,合并肺结核患者不建议应用利福平,肺曲菌球患者建议行手术治疗。
Objective To investigate the diagnosis and treatment of pulmonary aspergillosis and to improve its understanding of pulmonary aspergillosis. Methods The clinical data of 51 patients with pulmonary aspergillosis admitted to our hospital from January 2012 to January 2014 were retrospectively analyzed. The clinical manifestations, imaging findings, laboratory findings and treatment regimens were analyzed statistically. Results Pulmonary aspergillosis with pulmonary tuberculosis in 27 cases, cough, sputum symptoms in 32 cases, fever in 21 cases, chest tightness in 19 cases; chest imaging diffuse lung lesions in 29 cases; 18 cases found in Aspergillus; 47 patients Application of voriconazole sequential treatment, of which 41 cases of clinical symptoms improved. Conclusion Pulmonary aspergillosis is more common with pulmonary tuberculosis, clinical symptoms are not typical, the diagnosis is difficult to recommend as soon as possible pulmonary puncture, the application of voriconazole sequential treatment of satisfactory results, combined with pulmonary tuberculosis patients not recommended application of rifampin, pulmonary aspergillosis recommended surgery treatment.