白血病合并侵袭性肺真菌病的外科诊疗探讨

    The diagnosis and surgical treatment of leukemia complicated with invasive pulmonary fungal infection

    • 摘要: 目的:探讨白血病并发侵袭性肺真菌病(IPFI)的诊断、外科治疗方法。方法:11例白血病并发IPFI患者均行手术治疗,肺楔形切除5例,肺叶切除6例。术前术后抗真菌治疗2~12周,并随访8~46个月。结果:11例无一例围手术期死亡,术后病理组织检查曲霉菌感染7例,毛霉菌2例,隐球菌1例,曲霉菌和念珠菌混合感染1例。3例死于白血病复发,无真菌病复发。结论:外科切除持续存在的局限IPFI可以减少白血病患者化疗期间的真菌病复发。

       

      Abstract: Objective: To discuss the diagnosis and surgical treatment of leukemia complicated with invasive pulmonary fungal infection(IPFI).Methods:Eleven cases with leukemia complicated with IPFI were treated with operation,which included pulmonary wedge resection in 5 cases and pulmonary lobectomy in 6 cases.Al2 patients were treated with antifungal drugs before and after operation,and followed up after operation.Results:No case died during perioperative period,aspergillus infection in 7 cases,mucor infection in 2 case,cryptococcus infection in 1 case and mixed infection in 2 case were confirmed by pathologic examination.Three cases died of leukemia relapse and no fungus recurrence case was found.Conclusions:IPFI treated with surgical resection can reduce the fungal relapse during chemotherapy period of leukemia patients.

       

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