| 摘要: |
| ［摘要］ 目的 分析肺隐球菌病的临床特点、诊断、治疗及预后。方法 回顾分析23例确诊肺隐球菌病患者的高危因素、临床表现、影像学特点、确诊方法及治疗转归。结果 原发性肺隐球菌病21例（91.3%），继发性2例（8.7%），合并基础疾病5例（21.7%）。主要症状为咳嗽13例（56.5%）和胸痛9例（39.1%）。影像学主要表现为单发或多发结节/肿块18例（78.3%），主要分布在肺下叶（12例）。10例经皮穿刺肺活检确诊，12例经外科手术组织病理学确诊。行氟康唑治疗20例中（外科切除病灶10例），18例痊愈。结论 原发性肺隐球菌病较为常见，影像学特点对诊断有一定的提示意义。经皮穿刺肺活检是经济、安全、有效的确诊措施，氟康唑治疗疗效较好。 |
| 关键词: 肺隐球菌病 肺活检 氟康唑 |
| DOI：10.3969/j.issn.1674-3806.2013.10.02 |
| 分类号:R 56 |
| 基金项目:广西科学研究与技术开发计划项目（编号：桂科攻0816004-9）；广西面向农村和城市社区推广卫生适宜技术项目（编号：S200817） |
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| Clinical study of 23 patients with pulmonary cryptococcosis |
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CHEN Gui-rong, QIN Zhi-qiang, WEI Hai-ming, et al.
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Department of Respiratory Disease, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To investigate the clinical features, diagnosis, treatment and prognosis of pulmonary cryptococcosis.Methods The medical data of 23 cases of proven pulmonary cryptococcosis were studied retrospectively.Results Twenty-three cases were anti-HIV negative, 21 cases(91.3%) were primary pulmonary cryptococcosis and 2 cases(8.7%) were secondary ones. Cough(13 cases, 56.5%) and chest pain(9 cases, 39.1%) were the most common symptoms. Subpleural nodule/mass(18 cases, 78.3%) in the lower lobes(12 cases, 52.2%) were common radiologic findings. The definite diagnostic techniques included surgical lung biopsy(12 cases, 52.2%) and CT guided percutaneous lung biopsy (10 cases, 43.5%). Ten patients received surgical resection lesions and 10 internal patients were treated with fluconazole and 18 cases were cured.Conclusion Primary pulmonary cryptococcosis also occurs frequently. Radiologic findings can provide the clue for diagnosing pulmonary cryptococcosis. CT guided percutaneous lung biopsy is the most costless and efficient diagnostic technique. Most pulmonary cryptococcosis patients respond well to fluconazole. |
| Key words: Pulmonary cryptococcosis Lung biopsy Fluconazole |
