Furuse F, Nakanishi Y, Kotoh H, Inoue H, Yatsunami J, Ikeda T, Hara N
Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Jun;32(6):538-43.
We have performed percutaneous intracavitary treatment with anti-fungal reagents in 8 patients with pulmonary aspergilloma (6 males and 2 female) over the past decade. Ages ranged from 43 to 84 years old. All of the patients had underlying lung diseases, seven having old pulmonary tuberculosis and one pneumoconiosis. Five patients had a history of hemoptysis or hemosputum. Amphotericin B (AMPH) was injected daily in 5 patients, Fulconazol (FCZ) in 2 patients, and both in the remaining patient. For AMPH, maximal dose, total dose, and treatment duration were 20 to 50 mg, 285 to 1560 mg, and one to 7.5 months, respectively, and for FCZ, 20 to 30 mg, 450 to 1600 mg, 3 weeks to 4 months, respectively. At the end of treatment, fungus balls disappeared in 2 patients, decreased in size in 3 patients and were unchanged in 3 patients. After follow up periods of 7 months through 6.5 years, 5 of 6 patients remained in roentogenologically better condition than before treatment, and 3 of 5 patients with episodes of hemoptysis or hemosputum have not since had airway bleeding. The prognosis of the other two patients are unknown, since they died of other diseases before this survey. One patient had aspergillus empyema 7 months after treatment. There were no serious side effects or complications directly related to treatment. It was suggested that continuous percutaneous intracavitary treatment with anti-fungal reagents is safe and effective for inoperable patients with aspergilloma.
在过去十年中,我们对8例肺曲菌球患者(6例男性,2例女性)进行了抗真菌药物的经皮腔内治疗。年龄范围为43至84岁。所有患者均有基础肺部疾病,其中7例有陈旧性肺结核,1例有尘肺病。5例患者有咯血或痰中带血病史。5例患者每日注射两性霉素B(AMPH),2例患者注射氟康唑(FCZ),其余1例患者两种药物都用。对于AMPH,最大剂量、总剂量和治疗持续时间分别为20至50mg、285至1560mg和1至7.5个月,对于FCZ,分别为20至30mg、450至1600mg、3周至4个月。治疗结束时,2例患者的真菌球消失,3例患者的真菌球体积减小,3例患者的真菌球大小未变。经过7个月至6.5年的随访,6例患者中有5例在影像学上比治疗前状况更好,5例有咯血或痰中带血发作的患者中有3例此后未再出现气道出血。另外两名患者的预后未知,因为他们在本次调查前死于其他疾病。1例患者在治疗7个月后发生曲菌性脓胸。没有与治疗直接相关的严重副作用或并发症。提示对于无法手术的肺曲菌球患者,持续经皮腔内抗真菌药物治疗是安全有效的。