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[肺结核瘤外科治疗的临床与形态学依据]

[Clinical and morphological rationales for surgical treatment of lung tuberculomas].

作者信息

Vinokurov I I

出版信息

Probl Tuberk Bolezn Legk. 2009(4):28-31.

Abstract

The types of lung tuberculomas were determined in 302 patients, with respect to the characteristics of their clinical course and variations in their progression, during clinical, radiological, and morphological follow-ups. Drug-resistant Mycobacterium tuberculosis strains were found 3.4 times more frequently in patients with filled tuberculomas and 1.7 times more often in those with infiltrative-pneumonic types of tuberculomas as compared with layered tuberculomas. Based on the patterns of growth of various types of caseous lesions, a rationale for indications for surgical treatment of lung tuberculomas was developed. The proposed treatment strategy for lung tuberculomas makes it possible to initiate intensive chemotherapy in due time and to improve the efficiency of surgical interventions (98.6%), further reducing the duration of inpatient treatment by a factor of 1.5 and the number of tuberculosis relapses by a factor of 2.

摘要

在302例患者中,通过临床、放射学和形态学随访,根据肺结核瘤的临床病程特点及其进展变化确定了其类型。与分层结核瘤相比,在充满型结核瘤患者中发现耐多药结核分枝杆菌菌株的频率高3.4倍,在浸润性肺炎型结核瘤患者中发现的频率高1.7倍。根据各种类型干酪样病变的生长模式,制定了肺结核瘤手术治疗指征的理论依据。所提出的肺结核瘤治疗策略能够及时启动强化化疗,并提高手术干预的效率(98.6%),进一步将住院治疗时间缩短1.5倍,将结核病复发次数减少2倍。

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