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目的:总结百草枯肺儿童的肺部影像学改变和预后结局,提高随访诊治经验。方法:回顾性分析百草枯中毒合并肺部损害的52例患者的临床资料,统计分析肺部影响学改变情况,电话随访临床预后结局。结果:百草枯肺损害早期(<7天)主要表现为双肺纹理增多、斑片影、条索影,可出现气肿表现,如纵膈积气等;中期(7~14天)主要表现为斑片影及磨玻璃密度影,伴不同程度的间质改变;晚期(>14天)表现以肺间质纤维化为主。在明确预后结局的患儿中,病死率较高,为52.78%,平均死亡离服毒时间为8.84±7.81天。结论:百草枯肺是百草枯中毒的主要并发症和死亡原因,但儿童肺部发育与成人有差异,临床应加强对肺部影像学征象和临床预后结局的长期规范化的随访观察。
Objective: To summarize the lung imaging changes and prognosis of children with paraquat lung disease and to improve the experience of follow-up and treatment. Methods: The clinical data of 52 patients with paraquat poisoning complicated with lung injury were retrospectively analyzed. The changes of lung impact were statistically analyzed. The prognosis of telephone follow-up was also analyzed. Results: Paraquat lung damage in the early (<7 days) mainly manifested as increased lung markings, patchy shadow, the presence of emphysema, such as mediastinal gas accumulation; medium (7 to 14 days) the main performance For the patch shadow and ground glass density shadow, with varying degrees of interstitial changes; late (> 14 days) performance of interstitial fibrosis based. In patients with a clear prognosis, the case fatality rate was 52.78% with an average of 8.84 ± 7.81 days of death. CONCLUSION: Paraquat is the main complication and cause of death of paraquat poisoning. However, the development of lung in adults is different from that in adults. Long-term standardized follow-up of lung imaging features and clinical outcome should be strengthened clinically.