目的 研究吸入用乙酰半胱氨酸溶液在老年支气管扩张症急性加重中的应用价值.方法 选取我院60例支气管扩张急性加重患者,随机分为雾化0.9％生理盐水+吸入用乙酰半胱氨酸溶液的观察组30例和单纯雾化0.9％生理盐水的对照组30例,两组均予常规治疗,疗程10日,比较治疗前后的呼吸困难程度、咳嗽症状、咳痰难度、痰的性状、24h咳痰量、肺部哆音以及血气分析等指标变化,并观察治疗期间药物不良反应.评价两组的疗效及安全性.结果 两组咳嗽症状差异无统计学意义(P＞0.05),但观察组在其他五项观察指标和综合临床疗效的总有效率均明显高于对照组(P值均＜0.05).血气分析提示治疗后两组动脉血氧分压(PaO2)和动脉二氧化碳分压(PaCO2)水平均较治疗前改善,但观察组的两者水平均显著高于对照组(P＜0.05).治疗期间不良反应发生率与对照组比较差异无统计学意义(P＞0.05).结论 吸入用乙酰半胱氨酸溶液在老年支气管扩张症急性加重期中临床疗效显著,安全性高,值得临床推广.

Objective: To improve the understanding of chronic pulmonary aspergillosis (CPA) by analyzing the clinical manifestations, imaging and pathological features, diagnosis, treatment and prognosis of this disease. Methods: Cases of CPA, proven by microbiological evidence based on pathological study in Fuzhou General Hospital of the People's Liberation Army and Affiliated Fuzhou City First Hospital of Fijian Medical University from January 2006 to October 2016 were retrospectively analyzed. Results: The patients consisted of 17 males and 12 females, aged 24 to 75 years, mean (42±16) years. The underlying disorders included post-tuberculosis infection (n=11), bronchiectasis (n=8), chronic obstructive pulmonary disease (n=3) and diabetes mellitus (n=2). The main clinical symptoms included productive cough (n=25), chronic sputum production (n=18) and hemoptysis (n=15). Serum GM antigen tests were performed in 19 cases, and the result was positive in 12 patients. BALF GM antigen tests were performed in 2 cases, both of which were positive. Chest CT showed that the lesions were located predominantly in the upper lobes (n=24). Single cavity with interior irregular intraluminal material (n=16) and multiple cavities with interior irregular intraluminal material (n=10) were the most frequent CT findings, while the "air crescent sign" was found in 13 cases. In the 22 patients who underwent surgical treatment, Aspergillus filaments were found in the cavity (n=20) or the bronchi (n=2) of lung samples, and histological examination didn't show tissue invasion by fungi. Surgical therapy was performed in 22 patients, with complete remission in 19 cases, and death in 3 cases. Anti-fungal therapy was administered in 6 patients, with partial remission in 4, and stable disease in 2 cases. One patient was not treated. Conclusions: CPA is more frequently seen in patients with underlying chronic pulmonary diseases. The common CT findings are single or multiple cavities with interior irregular intraluminal materials. Aspergillus filament in the cavity or bronchi of lung samples, without parenchymal invasion, is the proof of CPA. The surgical cure rate for simple aspergilloma and aspergillus nodule is high, while the risk of operation for chronic cavitary disease is high. GM antigen test may be an evidence for diagnosing CPA.

<正>目前,治疗胸腔积液最常用的方法为中心静脉管置入胸腔中进行引流,该方法的优点是操作简便,危险性小,患者痛苦小,易于接受;但缺点是费用较高且管腔小,遇上结核性胸腔积液和类肺炎性胸腔积液患者,因胸腔积液中蛋白质含量高,积液容易在管腔中凝固导致管腔堵塞而造成治疗失

2007年2月22日我院收治一例重症肺炎合并成人呼吸窘迫综合征 (ARDS) 患者,后经省CDC检查、国家CDC复查确诊为人感染高致病性H5N1亚型禽流感.

22003 年至今我国确诊人感染高致病性H5N1亚型禽流感30例,经救治成功10例,死亡20例.现将福建省救治成功2例报道如下.