NHẬN XÉT ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG, CHỈ ĐỊNH ĐIỀU TRỊ NGOẠI KHOA BỆNH NẤM PHỔI MẠN TÍNH ASPERGILLUS TẠI BỆNH VIỆN PHỔI TRUNG ƯƠNG

Abstract

Background: To evaluate clinical and paraclinical characteristics and indications for surgical treatment of chronic pulmonary aspergillosis (CPA) caused by Aspergillus at the National Lung Hospital during the period 2023-2024. Methods: A retrospective cross-sectional study was conducted on 124 patients diagnosed with chronic pulmonary aspergillosis which underwent surgical treatment at the National Lung Hospital from January 2023 to June 2024. Data were analyzed using Stata software. Results: Among the 124 CPA patients, 72 were male (58.1%) and 52 were female (41.9%), with a mean age of 53±14 years. The main clinical symptom was hemoptysis (75.8%). Radiological imaging revealed CPA lesions predominantly in the upper lobes of both lungs—right upper lobe (54.17%) and left upper lobe (54.55%). A total of 115 patients underwent elective surgery, and 9 underwent emergency surgery. Video-assisted thoracoscopic surgery (VATS) was performed in 101 patients (81.45%), while open surgery was performed in 23 patients (18.54%). Lobectomy was the most common surgical indication, especially in the chronic cavitary pulmonary aspergillosis (CCPA) form. Conclusion: The diagnosis of chronic pulmonary aspergillosis is based on clinical presentation, chest computed tomography (CT), microbiological cultures, and histopathology. Surgical intervention is indicated in selected CPA cases and is considered to carry an acceptable complication rate, offering a chance for complete cure and symptomatic relief. VATS is a safe surgical option for appropriately selected patients.