Jackson M, Flower C D, Shneerson J M
Department of Respiratory Medicine, Papworth Hospital, Papworth Everard, Cambs.
Thorax. 1993 Sep;48(9):928-30. doi: 10.1136/thx.48.9.928.
The treatment of symptomatic pulmonary aspergillomas can be difficult. One approach has been to deliver antifungal drugs directly into the lung cavity. The use of this method of treatment is described in which an indwelling percutaneous catheter is used which avoids repeated needlings of the cavity and may allow extended treatment on a domiciliary basis.
Amphotericin B was delivered through indwelling percutaneous intracavitary catheters to treat five symptomatic episodes in four patients with pulmonary aspergillomas.
The treatment was well tolerated by all patients and their symptoms resolved in four of the five episodes. Two patients died, one from an unrelated bronchopneumonia and the other from advanced cachexia. Two patients remain symptom free after eight and 12 months.
Intracavitary administration of amphotericin through an indwelling catheter should be considered for any patient who has troublesome sputum production, haemoptysis, or systemic symptoms attributable to an aspergilloma.
有症状的肺曲菌球的治疗可能具有挑战性。一种方法是将抗真菌药物直接注入肺腔。本文描述了这种治疗方法的应用，即使用经皮留置导管，该方法避免了对肺腔的反复穿刺，并且可能允许在家庭环境中进行长期治疗。
通过经皮留置腔内导管给予两性霉素B，以治疗4例肺曲菌球患者的5次有症状发作。
所有患者对治疗耐受性良好，5次发作中有4次症状得到缓解。2例患者死亡，1例死于无关的支气管肺炎，另1例死于晚期恶病质。2例患者在8个月和12个月后仍无症状。
对于任何因曲菌球而有咳痰、咯血或全身症状的患者，应考虑通过留置导管进行腔内给予两性霉素。
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