低丙种球蛋白血症患者支气管扩张症的局限性肺切除术
Localised pulmonary resection for bronchiectasis in hypogammaglobulinaemic patients.
作者信息
Cohen A J, Roifman C, Brendan J, Mullen M, Reid B, Weisbrod G, Downey G P
机构信息
Department of Medicine, University of Toronto, Ontario, Canada.
出版信息
Thorax. 1994 May;49(5):509-10. doi: 10.1136/thx.49.5.509.
BACKGROUND
Bronchiectasis and pulmonary infections are common in patients with hypogammaglobulinaemia. Despite intravenous gammaglobulin treatment and appropriate antibiotics, a subgroup of patients remains with persistent localised pulmonary infection in segments where bronchiectasis had developed before appropriate treatment. As such localised pulmonary suppuration (segmental or lobar) may serve as a focus for progression of bronchiectasis, surgical resection of the involved segments may be considered. The outcome of pulmonary resection in four such patients is reported.
RESULTS
Surgery was well tolerated except for one postoperative empyema. Information on follow up is available from 3.5 to 5 years. All patients experienced considerable reduction of symptoms including cough, sputum production, antibiotic use, and hospital admissions.
CONCLUSIONS
Surgical resection of localised bronchiectatic segments should be considered in patients with hypogammaglobulinaemia with persistent localised suppuration and symptoms refractory to medical treatment.
背景
支气管扩张症和肺部感染在低丙种球蛋白血症患者中很常见。尽管进行了静脉注射丙种球蛋白治疗和使用了适当的抗生素，但仍有一部分患者在接受适当治疗前已发生支气管扩张的节段存在持续性局部肺部感染。由于这种局部肺部化脓（节段性或大叶性）可能成为支气管扩张进展的病灶，因此可考虑对受累节段进行手术切除。本文报告了4例此类患者肺切除的结果。
结果
除1例术后发生脓胸外，手术耐受性良好。随访信息时间为3.5至5年。所有患者的症状，包括咳嗽、咳痰、抗生素使用和住院次数均有显著减少。
结论
对于低丙种球蛋白血症且存在持续性局部化脓且药物治疗难以控制症状的患者，应考虑对局部支气管扩张节段进行手术切除。
Zotero 插件