(Data map)
[Source: Guangzhou Daily client]
Aged 44, Ah Qi (not his real name) began to cough repeatedly, cough up pus, phlegm, hemoptysis and other symptoms many years ago, and also suffered from the collapse of the right thorax, which seriously affected the quality of life. At the local hospital, chest CT showed "right upper lung cavity with spherical content, right pleural thickening". Qi went to Guangzhou Chest Hospital for consultation. The doctor gave him a bronchoscope examination, and found that "the right upper lobe bronchial mucosa was congested and swollen, and fungal balls were visible in the apical cavity". The branch examination pathology showed aspergillus infection, and the final diagnosis was secondary aspergillus infection and old pulmonary tuberculosis in the right upper pulmonary cavity. After consultation, the surgical experts suggested that the right upper lung lesion should be removed surgically, but Qi chose medical treatment because she was unwilling to operate.
Tang Chunmei, Chief Physician of the Third Department of Internal Medicine of Guangzhou Chest Hospital, improved Ah Qi's symptoms significantly after three times of removal of aspergillus under bronchoscope. The reexamination of bronchoscopy indicated that "the fungal mass was cleared". Now Ah Qi has no obvious cough, expectoration, hemoptysis and other discomfort, greatly improving the quality of life.
It is reported that in the past 20 years, the expert team of Guangzhou Chest Hospital has carried out more than 2000 bronchoscopic interventions for more than 800 patients who were deeply troubled by pulmonary aspergillus, and has accumulated rich experience in diagnosis and treatment.
Experts said that pulmonary tuberculosis is easy to form cavities due to the necrosis of lung tissue. If combined with bronchial tuberculosis, it will lead to distortion, stenosis and even blockage of the drainage bronchus. Therefore, even after the cure of pulmonary tuberculosis, the cavitary lesions in some cases are difficult to close and disappear, making the cavity after pulmonary tuberculosis prone to repeated infection. Aspergillus infection is the most common, and pulmonary aspergilloma is one of the types.
The clinical symptoms caused by pulmonary aspergilloma in the pulmonary tuberculosis cavity are mainly cough, expectoration, and hemoptysis, which have typical imaging characteristics. In addition to the development of modern medical inspection technology and bronchoscopic interventional examination technology, the contents of the cavity are observed under the microscope through the bronchoscope into the pulmonary tuberculosis cavity, and pathological tissue biopsy is performed, So that pulmonary aspergillosis can be diagnosed in time.
Tang Chunmei introduced that at present, the common treatment methods for pulmonary aspergilloma include surgery, antifungal drugs, antifungal drugs combined with bronchoscopic intervention. Surgical resection of the focus can be radical, but for patients with extensive pulmonary lesions, poor pulmonary function or unwilling to accept surgical treatment, antifungal drugs combined with bronchoscopic intervention can be selected. The number of times of treatment under bronchoscopy varies from person to person. Some patients may be cleaned up once or twice, but some complicated patients may need more than 10 times to clean up.
"In clinical practice, we have encountered that some patients still have fungi in their cavities after using antifungal drugs for several years, and their cough, sputum, and even hemoptysis have not completely improved. Bronchoscopic clearance treatment can help patients recover as soon as possible to achieve the goal of cure." Tang Chunmei said.
Article/Guangzhou Daily · Xinhuacheng Reporter: Zhang Qingmei Correspondent: Wu Zhenjie, Jing Shilai
Guangzhou Daily · Xinhuacheng Editor: Wu Ren
key word: Bronchoscope
interventional therapy
Guangzhou Daily
