Hu Xinxin, Hulme Kathryn, Brien Liana, Hutabarat Sonya Natasha, Harrington Zinta
Liverpool Hospital, Department of Respiratory and Sleep Medicine, Liverpool, Australia.
Joint first authors.
Breathe (Sheff). 2024 Oct 1;20(3):230234. doi: 10.1183/20734735.0234-2023. eCollection 2024 Oct.
Chronic pulmonary aspergillosis has a range of manifestations from indolent nodules to semi-invasive infection. Patients may be asymptomatic or have chronic symptoms such as cough and weight loss or present with life-threatening haemoptysis. The physician can choose from a range of available therapies including medical therapy with antifungals, minimally invasive therapy with intracavitary antifungal therapy and surgery involving open thoracotomy or video-assisted thoracoscopic surgery. The patients with the most severe forms of pulmonary infection may not be surgical candidates due to their underlying pulmonary condition. The management of haemoptysis can include tranexamic acid, bronchial artery embolisation, antifungals or surgery. There are few controlled studies to inform clinicians managing complex cases, so a multidisciplinary approach may be helpful.
慢性肺曲霉病有一系列表现，从惰性结节到半侵袭性感染。患者可能无症状，或有咳嗽、体重减轻等慢性症状，或出现危及生命的咯血。医生可从一系列可用治疗方法中进行选择，包括抗真菌药物的药物治疗、腔内抗真菌治疗的微创治疗以及涉及开胸手术或电视辅助胸腔镜手术的外科手术。肺部感染最严重形式的患者由于其潜在的肺部状况可能不适合手术。咯血的处理可包括氨甲环酸、支气管动脉栓塞、抗真菌药物或手术。很少有对照研究为管理复杂病例的临床医生提供指导，因此多学科方法可能会有所帮助。
