尼泊尔一例耐多药结核病中Rasmussen动脉瘤的罕见病例报告
Aashish Lamichhane1, Apil Pokhrel1, Sadish Sharma2
1Provincial Center for Disease Control, Pokhara, Kaski, Nepal.
Annals of medicine and surgery (2012)
|October 13, 2026
抽象的
引言与重要性:
Rasmussen 动脉瘤是一种影像学表现,也是肺结核引起咯血的少见原因。它是由于结核空洞邻近的炎症导致肺动脉壁削弱所致。
病例报告:
我们报告一例52岁男性患者,诊断为肺结核,在接受抗结核治疗期间仍出现反复咯血。通过线探针检测进行的细菌学检查显示对利福平和异烟肼耐药,确诊为耐多药结核病(MDR-TB)。行CT肺动脉造影(CT-PA)检查,结果显示左肺上叶空洞旁存在一条扩张的血管通道,提示为Rasmussen动脉瘤。该病例采用经动脉栓塞术进行治疗,随后启动针对耐多药结核病的二线治疗方案。
临床讨论:
由于Rasmussen动脉瘤较为罕见,在结核病患者出现大咯血时常常被忽视。若不及时治疗,可能危及生命。本病例凸显了及时进行检查和干预以处理该并发症并防止病情进一步恶化的临床重要性。
结论:
Rasmussen动脉瘤是咯血的罕见病因,尤其多见于空洞性或耐多药结核病(MDR-TB)患者。通过CT肺动脉造影(CT-PA)早期诊断,并采用血管内介入方法进行治疗,可能挽救生命。
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