Giron J M, Poey C G, Fajadet P P, Balagner G B, Assoun J A, Richardi G R, Haddad J H, Caceres J C, Senac J P, Railhac J J
Department of Radiology, Hôpitaux de Toulouse, CHU Purpan, France.
Radiology. 1993 Sep;188(3):825-7. doi: 10.1148/radiology.188.3.8351356.
Fifteen patients with active inoperable pulmonary aspergilloma underwent percutaneous injection of a special therapeutic paste of glycerin and amphotericin B. This paste was warmed just prior to injection, and filling of the lesional cavity was achieved in one session if it was possible to obtain anaerobic conditions for destruction of the aspergilloma. Injection was performed with computed tomographic guidance with use of an 18-gauge flexible needle and with administration of anti-coughing analgesia. Follow-up was continued for 7 months on average. Filling of the lesion cavities required three sessions on average because of cough or bronchospasm. In 12 cases the aspergilloma regressed within 3 months and results at serology became negative. In three cases, there was no change in the cavity, but hemoptysis did not recur. Results in this series confirm the feasibility and efficacy of this palliative treatment.
15例患有活动性不可手术切除肺曲菌球的患者接受了甘油和两性霉素B特殊治疗膏的经皮注射。这种膏剂在注射前刚刚温热，如果能够获得破坏曲菌球的厌氧条件，则在一次治疗中即可实现病灶腔的填充。在计算机断层扫描引导下，使用18号柔性针进行注射，并给予镇咳镇痛。平均持续随访7个月。由于咳嗽或支气管痉挛，病灶腔的填充平均需要三次治疗。12例患者的曲菌球在3个月内消退，血清学结果转为阴性。3例患者病灶腔无变化，但咯血未复发。本系列结果证实了这种姑息治疗的可行性和有效性。
