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目的 探讨严重急性呼吸综合征 (SARS)患者康复期的CT表现。方法 随访观察 6 5例确诊为SARS的康复者 ,根据病史分为重症 2 1例 ,轻症 4 4例 ,进行多层螺旋CT和高分辨率CT扫描、肺功能等检查。结果 2 8例CT扫描未见异常。其余CT表现为 :(1)磨玻璃样密度灶 35例 ,包括 :局限斑片状磨玻璃样密度病灶 11例 ;多叶多段磨玻璃样密度灶 19例 ;双肺弥漫磨玻璃样密度病灶 5例。 (2 )小叶内间质及小叶间隔增厚 30例。 (3)胸膜下弧线影 9例。 (4 )不规则纤维索条影 19例。(5 )牵拉性细支气管扩张 3例。 (6 )结节状气腔实变病灶 2例。 (7)空洞病灶 1例。未见明显纵隔淋巴结肿大和胸腔积液。多次复查肺内影像及肺功能均有好转。比较重症组和轻症组CT表现及肺功能指标差异有显著意义 (P <0 0 5 )。结论 部分SARS康复期患者肺部表现基本正常 (2 8/ 6 5 ,占 4 3 1% )。磨玻璃样密度病灶为康复期的主要CT表现 (35 / 6 5 ,占 5 3 8% ) ,并伴有程度不等的肺间质增生。重症组较轻症组患者肺内表现严重 ,肺功能差。随着时间的延长 ,肺内病变及肺功能逐渐好转。
Objective To investigate the CT manifestations of patients with severe acute respiratory syndrome (SARS) during convalescence. Methods Totally 65 cases of SARS patients were followed up. According to their medical history, they were divided into two groups: severe cases (21 cases) and mild cases (44 cases). Multi-slice spiral CT, high resolution CT scan and pulmonary function tests were performed. Results 28 cases of CT scan showed no abnormalities. The remaining CT manifestations were as follows: (1) 35 cases of ground-glass-like density lesions, including 11 cases of limited patch-like ground-glass density lesions, 19 cases of multi-lobe multi-section ground glass density lesions, example. (2) leaflet interstitial and interlobular septal thickening in 30 cases. (3) 9 cases of subpleural arc. (4) irregular fiber cable shadow 19 cases. (5) Traction bronchiectasis in 3 cases. (6) nodular air cavity consolidation lesions in 2 cases. (7) 1 case of empty lesions. No obvious mediastinal lymph nodes and pleural effusion. Multiple lung imaging and pulmonary function have been reviewed. Comparing the severity of severe and mild cases of CT and pulmonary function indicators have significant differences (P <0 05). Conclusions The performance of lungs in some SARS convalescent patients is basically normal (28/65, accounting for 43.1%). Abrasive glass-like density lesions were the major CT findings during rehabilitation (35/65, 53.8%), accompanied by varying degrees of pulmonary interstitial fibrosis. Severe group of mild disease patients with severe lung performance, poor lung function. With the extension of time, lung lesions and lung function gradually improved.