【摘要】：目的:探討氣管真菌病的臨床特點(diǎn),提高對(duì)該病的認(rèn)識(shí),盡早診斷,及時(shí)治療,以獲得更好的臨床療效,改善預(yù)后。方法:回顧性分析2012年3月至2016年3月期間于山東省立醫(yī)院住院并臨床確診的12例氣管真菌病患者的病歷資料,對(duì)其年齡、性別、臨床特點(diǎn)、病原學(xué)、診斷和治療方法及轉(zhuǎn)歸進(jìn)行分析。結(jié)果:12例氣管真菌病患者年齡14歲-74歲,中位年齡59歲,年齡≥60歲者5例(5/12),其中男性4例,女性8例,男女比例1:2。12例患者中,曲霉菌3例,其余患者未明確具體病原菌類(lèi)型;臨床癥狀無(wú)特異性,以發(fā)熱、咳嗽咳痰為主,其次為痰中帶血;大多有基礎(chǔ)疾病,如腫瘤、結(jié)核、糖尿病、COPD等致免疫低下疾病;危險(xiǎn)因素主要有應(yīng)用糖皮質(zhì)激素、長(zhǎng)期應(yīng)用廣譜抗生素、放化療等;研究的12例氣管真菌病均由病理證實(shí)而確診;鏡下表現(xiàn)多見(jiàn)黃白色或暗褐色新生物附著;7例患者經(jīng)治療后取得較好的臨床療效,2例患者因發(fā)生大咯血搶救無(wú)效死亡,3例患者未行抗真菌治療,隨訪未見(jiàn)真菌感染的證據(jù),考慮為氣管內(nèi)定植菌。結(jié)論:局限于氣管的真菌病較少見(jiàn),臨床表現(xiàn)亦無(wú)特異性,容易漏診及誤診。大多有基礎(chǔ)疾病,對(duì)可疑病例進(jìn)行多方面的檢查,根據(jù)患者的自身情況及疾病特點(diǎn),合理采用抗真菌藥物是治療的關(guān)鍵。有些真菌如曲霉菌、毛霉菌可侵犯血管,導(dǎo)致致命性大咯血,需提高警惕。無(wú)癥狀患者未應(yīng)用抗真菌藥物,隨訪未發(fā)展成為侵襲性真菌感染,考慮為氣管內(nèi)定植菌,但需定期隨訪。
[Abstract]:Objective: to investigate the clinical features of tracheobronchomycosis, to improve the understanding of the disease, to diagnose and treat it as soon as possible, to obtain better clinical effect and to improve the prognosis. Methods: the medical records of 12 cases of tracheobronchomycosis hospitalized in Shandong Provincial Hospital from March 2012 to March 2016 were retrospectively analyzed. Diagnosis, treatment and outcome were analyzed. Results: the age of 12 patients with tracheobronchomycosis was 14 to 74 years old, the median age was 59 years old, the age 鈮，

本文編號(hào)：2285334