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曲菌球病患者常因长期肺部疾病,手术和术后处理难度较大,死亡率高。总结我院手术治疗曲菌球的病例,探讨其手术适应证、手术疗效和术后并发症。研究对象我院1990年1月至2005年12月手术治疗的48例肺曲菌球患者,男20例,女28例,平均年龄45岁(25～73岁)。术后均经病理检查确诊。根据 Belcher 分类,将曲菌球分为两类:单纯型曲菌球为薄壁空洞,周边肺组织基本正常;复杂型为厚壁空洞或存在严重的肺或胸膜病变。结果右肺曲菌球34例,左肺12例;肺上叶27例,肺中叶5例,肺下叶14例,双侧病变2例。单纯型19例,除1例伴先天性囊肿内外,均未发现肺基础病变。复杂型29例,以结核最常见(12例),其次为支气管扩张(9例)、肺脓肿(3例)及其他病变(5例)。7例无症状,仅影像学偶然发现。咯血21例,咳嗽13例,咳痰9例,低热6例,体重减轻5例。
Aspergillosis patients often due to long-term lung disease, surgery and postoperative treatment more difficult, high mortality. Summarize the surgical treatment of aspergillosis cases in our hospital to explore its indications for surgery, surgical efficacy and postoperative complications. Participants 48 patients with pulmonary aspergilloma who underwent surgery in our hospital from January 1990 to December 2005, 20 males and 28 females, with an average age of 45 years (25-73 years). Postoperative pathological examination confirmed. According to the classification of Belcher, Aspergillus sp. Is divided into two types: Aspergillus simplex as thin-walled cavity, the surrounding lung tissue is basically normal; complex type thick-walled hole or there is a serious lung or pleural disease. Results 34 cases of right lung aspergillosis, left lung in 12 cases; 27 cases of upper lobe, middle lobe in 5 cases, 14 cases of lower lobe, bilateral lesions in 2 cases. 19 cases of simple type, except one case with congenital cysts, both inside and outside, no found lung lesions. 29 were complicated, the most common was tuberculosis (12 cases), followed by bronchiectasis (9 cases), lung abscess (3 cases) and other lesions (5 cases). 7 cases were asymptomatic, only the imaging findings by chance. 21 cases of hemoptysis, 13 cases of cough, sputum in 9 cases, 6 cases of fever, weight loss in 5 cases.