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目的:探讨喉部病变对皮肌炎纵隔气肿预后的影响。方法:回顾性分析42例皮肌炎患者的临床资料,通过分析声嘶、喉部病变患者纵隔气肿的发病率及转归,评估其对皮肌炎患者纵隔气肿诊断和预后的价值。结果:42例皮肌炎患者中20例并发间质性肺炎,发病率为47.6%;4例出现声嘶,发病率为9.5%;3例并发纵隔气肿,发病率为7.1%。喉镜显示1例患者的声带表现为充血,3例声带表现为双侧声带白色改变,所有患者声带运动正常。3例声带白色改变的患者均并发纵隔气肿,并因呼吸衰竭死亡。声嘶及声带病变患者气肿的发生率及死亡率与无声带病变患者相比,差异有统计学意义(P<0.01)。结论:声嘶、喉部病变与皮肌炎患者并发纵隔气肿的产生及预后不良有一定的相关性。
Objective: To investigate the effect of laryngeal lesions on the prognosis of mediastinal emphysema in dermatomyositis. Methods: The clinical data of 42 patients with dermatomyositis were retrospectively analyzed. The incidence and outcome of mediastinal emphysema in patients with hoarseness and laryngeal diseases were analyzed retrospectively to evaluate the value of diagnosis and prognosis of mediastinal emphysema in patients with dermatomyositis. Results: In 42 cases of dermatomyositis, 20 cases had interstitial pneumonia, the incidence was 47.6%. In 4 cases, the incidence of hoarseness was 9.5%. In 3 cases, the incidence of pneumomediastinum was 7.1%. Laryngoscopy showed one patient’s vocal cord showed congestion, three vocal cords showed bilateral vocal cord white change, all patients with normal vocal cord movement. Three patients with vocal cord white changes were complicated with pneumomediastinum and died of respiratory failure. Hoarseness and vocal cord lesions in patients with emphysema incidence and mortality compared with patients without vocal cord lesions, the difference was statistically significant (P <0.01). Conclusion: Hoarseness, laryngeal lesions and dermatomyositis patients with mediastinal emphysema and poor prognosis have some relevance.