肺结核球手术指征的探讨

中国防痨杂志 ›› 2001, Vol. 23 ›› Issue (5): 305-307.

肺结核球手术指征的探讨

张雷；丁嘉安；姜格宁；许成文；陈恒；

上海市肺科医院上海 200433；

出版日期:2001-05-10 发布日期:2001-11-03

A discussion on surgical indication to the lung tuberculoma

ZHANG Lei,DING Jia-an,JIANG Ge-ning,et al.

Thoracic Surgery Department of Shanghai Pulmonary hospital,Shanghai 200433

Online:2001-05-10 Published:2001-11-03

摘要/Abstract

摘要： 目的　讨论肺结核球误诊原因，提出手术指征及手术方式。方法报告及分析108例肺结核球病例资料，结合文献进行讨论。结果肺结核球108例，占同期手术总数2.2%。术前误诊37例，其中误诊为肺癌30例 (病灶＜3cm者22例)，良性肿瘤6例，曲菌球1例。X线胸片表现不典型40例 (病灶边缘有毛刺、分叶状、伴有肺门及纵隔淋巴结肿大等)。病灶发生在肺上叶85例 (78.7%)，有结核中毒症状者58例 (53.8%)。30例因抗结核治疗效果不佳而手术。结论在肺部孤立病灶的诊断中应考虑结核球的可能，应结合临床全面分析，尽可能找出组织病理学依据，使部分结核球病人避免手术治疗。结合文献资料提出肺结核球的手术指征及手术方式。

关键词: 肺结核球, 手术指征

Abstract: Objective To discuss the causes of misdiagnosis of lung tuberculoma and the indication and pattern of operation.Methods To analyze 108 cases diagnosed as tuberculoma operated and literature reviewed.Results 108 cases were diagnosed as tuberculoma (2.2% of total operated cases in the same period),37 misdiagnosed with 30 cases diagnosed as lung cancer (22 cases with their lesion ≤3cm in diameter),6 benign tumour,1 aspergilloma.40 cases with atypical shadow and with enlarged hilar and mideasternal lymphnodes in the chest film.85 cases (78.7%) lesions located in upper lung field.58 cases (53.8%) had symptoms as tuberculosis.30 cases were operated due to no effective Results by antiTB treatment.Conclusion Based on these results,the possibility and the existence of tuberculoma should be considered in single isolated lung lesion and it is better to have a lung biopsy for pathological examination if possible.The indication and pattern of operation in lung tuberculoma were reviewed.

Key words: Lung tuberculoma, Surgical indication

张雷,丁嘉安,姜格宁,许成文,陈恒,. 肺结核球手术指征的探讨[J]. 中国防痨杂志, 2001, 23(5): 305-307.

ZHANG Lei,DING Jia-an,JIANG Ge-ning,et al.. A discussion on surgical indication to the lung tuberculoma[J]. Chinese Journal of Antituberculosis, 2001, 23(5): 305-307.