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目的探讨急性氯气中毒患者胸部影像与临床表现的关系及其实际价值。方法回顾性分析2011年10月16日某化工厂氯气泄漏事故中21例中重度中毒患者的胸部影像(X线胸片及胸部CT)表现,按临床表现分:急性期、消散期、恢复期进行分期观察,并将影像表现与临床表现对比分析。结果急性期胸部影像表现为两肺纹理增多、模糊及弥漫性磨玻璃样密度影共17例,临床表现为支气管炎和支气管周围炎;两肺片絮状模糊影及实变影4例,临床表现为支气管肺炎、间质性或肺泡性肺水肿。消散期:胸部影像捕获到消散期改变5例,表现为片絮状及大片实变影较前有所吸收,临床表现较前好转。恢复期:15例复查患者,两肺纹理增多8例,出现纤维索条影4例,残留腺泡样磨玻璃密度影3例,所有患者临床均表现为基本痊愈。结论氯气中毒的分期胸部影像表现与临床表现密切相关,整体表现基本一致。各期胸部影像表现能准确反映肺损害的严重程度,为临床治疗方案的选择提供重要依据。
Objective To investigate the relationship between thoracic imaging and clinical manifestations in patients with acute chlorine poisoning and its practical value. Methods A retrospective analysis was performed on the chest radiographs (X-ray and chest CT) of 21 moderate-to-severe poisoned patients in a chlorine leakage accident in a chemical plant on October 16, 2011. According to the clinical manifestations, acute phase, dissipative phase, convalescence phase Staging observation, and image performance and clinical performance of comparative analysis. Results In the acute stage, the thoracic images showed an increase in both the lungs texture, fuzzy and diffuse glass-like density of 17 cases, the clinical manifestations of bronchitis and bronchial inflammation; The performance of bronchial pneumonia, interstitial or alveolar pulmonary edema. Dissipation period: the capture of the chest to dissipate the change in 5 cases, showed a piece of flocculent and large consolidation before the shadow has been absorbed, the clinical manifestations improved. Convalescence: 15 cases of review of patients, two lungs increased in 8 cases, there were 4 cases of fiber cable shadow, residual acinar-like glass density in 3 cases, all patients were clinically the performance of the basic recovery. Conclusion Clinic imaging of chest gas staging of chlorine poisoning is closely related to clinical manifestations, and the overall performance is basically the same. Each stage of chest imaging can accurately reflect the severity of lung damage, providing an important basis for the choice of clinical treatment options.