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目的 探讨严重急性呼吸综合征 (SARS)胸片的演变规律。方法 回顾性分析 5 4例临床确诊的SARS病人的胸片 ,观测不同时期病变的位置、形态、数量、面积及密度的动态变化。结果 在首次胸片上 ,5 4例中 ,单侧受累33例 ,其中 5例在随访胸片中转变为双侧受累 :双侧受累者 2 1例 ,以下肺野 (6 4 .82 % )和肺中带 (94 .4 4 % )多见。病变形态演变具有 3种模式 ,以斑片状 片絮状 局部肺纹理增粗 完全吸收模式 (6 4 .82 % )多见。病变数量演变包含 5种模式 ,以单片型 (4 0 .74 % )多见。病变面积演变包括单峰型 (79.6 3% )、双峰型 (12 .96 % )和持续恶化型 (7.4 1% )。病变密度演变包含单峰型 (5 7.6 9% )、双峰型 (2 9.4 9% )、三峰型 (7.6 9% )和持续恶化型 (5 .13% )。病程和病变占整个肺野最大比例在病变形态、数量、面积和密度的不同演变类型间均存在显著性差异。结论 SARS病人胸片的演变具有一定规律 ,演变模式对患者预后具有提示作用。
Objective To investigate the evolution of severe acute respiratory syndrome (SARS) chest radiograph. Methods We retrospectively analyzed the chest radiographs of 54 clinically diagnosed SARS patients and observed the dynamic changes in the location, morphology, number, area and density of lesions at different stages. Results On the first chest radiograph, 33 cases were unilateral in 54 cases, of which 5 cases were involved in the bilateral involvement in the follow-up chest radiographs: 21 cases with bilateral involvement, 64.42% with lung field Pulmonary band (94.4%) more common. There are three modes of morphological changes of the lesion, which are more common in patchy flaky local lung texture thickening complete absorption mode (64.42%). The evolution of the number of lesions contains five kinds of patterns, monolithic (40.74%) more common. Lesion area evolution included unimodal (79.6%), bimodal (12.96%) and persistent deterioration (7.4%). Lesion density evolution included unimodal type (5 7.69%), bimodal type (2 9.49%), trimodal type (7.69%), and persistent deterioration type (5.13%). The largest proportion of pathological and pathological changes in the entire lung field showed significant differences in different types of lesions, morphology, number, area and density. Conclusion The evolution of chest X-ray in patients with SARS has some rules, and the evolving mode has a prompting effect on the prognosis of patients.