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肺挫伤的特征是受伤部位水肿、出血,无肺撕裂,病理改变涉及肺间质和肺实质,以肺间质、肺泡内出血、渗出、水肿和微小肺不张为主要表现。早期明确诊断和及时干预,对临床治疗和转归尤为重要。本文对经临床及CT检查确诊胸部闭合性肺挫伤42例的CT表现及转归进行了分析。首诊CT病灶类型包括间质型肺挫伤19例(45.2%),以肺纹理增粗、增多、紊乱、模糊为主要表现;云雾型肺挫伤14例(33.3%),以毛玻璃样、云絮状阴影为主要表现;弥散实变型肺挫伤4例(9.5%),以散在小斑片状、斑点状为主要表现;节段实变型肺挫伤5例(11.9%),以大片状实变影为主要表现。伤后12~48h复查CT,病灶较首诊CT有不同程度进展12例,占28.6%;发现新病灶6例,占14.3%;病灶吸收好转8例,占19.0%;病灶未见显著变化16例,占38.1%。间质型13例吸收最快,伤后1~5天基本吸收消散;云雾型10例吸收较快,伤后3~8天基本吸收消散;弥散实变型及节段实变型9例吸收最慢,伤后5~30天吸收消散。本结果提示,肺挫伤CT表现复杂多样,其主要与创伤程度、病变发展阶段、伤后CT检查时间等因素有关;CT随访复查,对于临床治疗效果的观察、病情演变和转归判定均具有重要参考价值。
Pulmonary contusion is characterized by edema, hemorrhage and no lung tear in the injured area. The pathological changes involve the interstitial lung and the parenchyma of the lung. The main manifestations are pulmonary interstitial, alveolar hemorrhage, exudation, edema and micro-atelectasis. Early diagnosis and timely intervention, clinical treatment and prognosis is particularly important. In this paper, CT findings and prognosis of 42 patients with closed pulmonary contusion of the chest confirmed by clinical and CT examination were analyzed. The first diagnosis of CT lesions included interstitial lung contusion in 19 cases (45.2%), with the lungs thickening, increased, disorder, blurred as the main performance; cloud of pulmonary contusion in 14 cases (33.3%), 4 cases (9.5%) were diffuse consolidation type pulmonary contusion, scattered in small patchy, spot-shaped as the main performance; segmental consolidation type pulmonary contusion in 5 cases (11.9%), Film as the main performance. Twelve to 48 hours after injury, CT was retrospectively reviewed. Twelve cases (28.6%) were found to have lesions of varying degrees compared with those of the first diagnosis. Six cases of new lesions were found (14.3%), and eight cases (19.0%) of lesions showed no significant changes For example, 38.1%. The interstitial 13 cases absorbed the fastest, and basically absorbed and dissipated 1 to 5 days after injury. In the 10 cases, the absorption in the cloud-type was faster and the absorption was almost dissipated in 3-8 days after injury. In the diffuse consolidation and segment consolidation, the absorption was the slowest , 5 to 30 days after injury absorb dissipated. The results suggest that pulmonary contusion CT complicated and varied, mainly with the degree of trauma, the stage of disease development, post-injury CT examination and other factors; CT follow-up review of clinical treatment for the observation of the evolution of the disease and the outcome of the decision is important Reference value.