Butz R O, Zvetina J R, Leininger B J
Chest. 1985 Mar;87(3):356-8. doi: 10.1378/chest.87.3.356.
We studied 33 consecutive patients with tuberculous pulmonary cavities complicated by fungus balls to evaluate their treatment. Nineteen had surgical resection for massive or recurrent bleeding or possibility of tumor. One patient died of postpneumonectomy empyema (30-day surgical mortality, 5 percent). Fourteen had no surgery. No patient died of hemoptysis. Respiratory failure contributed most often to death. Hepatic complications and other problems of alcoholism were also prominent. Good results can be obtained by resection in these severely ill patients if care is taken to preserve functioning pulmonary tissue and to avoid complications of alcoholic hepatic disease. Within these constraints, tuberculous cavities complicated by mycetomas should be resected for massive or recurrent hemoptysis.
我们研究了33例连续性结核性肺空洞合并曲菌球患者以评估其治疗情况。19例因大量或反复出血或存在肿瘤可能而接受了手术切除。1例患者死于肺切除术后脓胸(30天手术死亡率为5%)。14例未接受手术。无患者死于咯血。呼吸衰竭是最常见的死亡原因。肝脏并发症和其他酒精中毒问题也很突出。对于这些重症患者,如果注意保留有功能的肺组织并避免酒精性肝病的并发症,手术切除可取得良好效果。在这些限制条件下,结核性空洞合并霉菌球若出现大量或反复咯血,应行手术切除。