Clinical Manifestations and Surgical Treatment Outcomes of Pulmonary Aspergilloma

肺部麴菌瘤接受開刀患者之臨床表現及治療預後

林哲良(Che-Liang Lin) ； 吳明和(Ming-Ho Wu) ； 賴吾為(Wu-Wei Lai) ； 陳昌文(Chang-Wen Chen) ； 張漢煜(Han-Yu Chang) ； 薛尊仁(Tzuen-Ren Hsiue)

《胸腔醫學》 20卷5期 (2005/10) Pp. 380-385

https://doi.org/10.29806/TM.200510.0004

摘要

背景：肺部麴菌瘤通常是起因於麴菌的群聚增殖在受損的支氣管，肺囊腫，或是在有疾病肺的病人的空腔。在本文中，我們分析了27個肺部麴菌瘤接受開刀的病人他們的臨床表現，影像學分佈，以及治療的預後。
方法：從1988年8月到2003年11月，在國立成大醫院有27位病患被診斷為肺部麴菌瘤並接受開刀治療。我們以回溯的方式整理了這些病人的資料。
結果：病人的平均年齡是54.9±15.2歲，男性與女性的比例是17:1，而且最常見的症狀是咳血，有25個病人發生(93%)。最常合併的肺部疾病是陳舊性肺結核(89%)，而且兩肺的上肺葉是最常侵犯的部位。空氣弦月徵候在本文中的27個病人可以發現14例。我們的病人都接受了手術切除證實診斷。有5個病人有術後的併發症，三位患者術後死亡，開刀的死亡率是11%(3/27)。
結論：肺部麴菌瘤通常發生在已有肺部疾患的病人身上。對於麴菌瘤的患者通常會有咳血的症狀，而且多半是大量甚至會致命的咳血，而手術切除是主流的治療方式。在本文可發現，雖然有少數的病人發生併發症及死亡，不過手術的預後還是相當不錯。

關鍵字

肺部麴菌瘤 ； 咳血

並列摘要

Background: Pulmonary aspergilloma usually arises from the in-growth of colonized Aspergillus from a damaged bronchial tree, a pulmonary cyst, or from the cavities of patients with underlying lung diseases. In the present study, we analyzed the clinical features, radiographic pictures, and surgical outcomes of 27 patients with pulmonary aspergilloma.
Methods: Twenty-seven patients were diagnosed with pulmonary aspergilloma and underwent surgical treatment at National Cheng-Kung University Hospital, between August 1988 and November 2003. Their medical records and data were reviewed retrospectively.
Results: The mean age of the patients (mean ± SD) was 54.9±15.2 years; the male to female ratio was 1.7:1; and the most common symptom was hemoptysis, which occurred in 25 patients (93%). The most common underlying disease was pulmonary tuberculosis (89%), and the upper lobes of both lungs were the most frequently involved sites. An air-meniscus sign in the chest radiograph was found in 14 of the 27 patients. All of our patients finally underwent surgical resection, and post-operative complications were reported in 5 patients. The postoperative mortality was 11%(3/27).
Conclusion: Pulmonary aspergilloma usually develops in patients with underlying lung diseases. Resectional lung surgery is considered the mainstay of therapy for pulmonary aspergilloma with the common presentation of hemoptysis, which is frequently massive and occasionally fatal. The post-operative outcome was well tolerated in the present study.

並列關鍵字

pulmonary aspergilloma ； hemoptysis