国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2010年
10期
592-596
,共5页
脓毒性肺栓塞%感染性心内膜炎%临床特征%影像学表现%基础疾病%并发症
膿毒性肺栓塞%感染性心內膜炎%臨床特徵%影像學錶現%基礎疾病%併髮癥
농독성폐전새%감염성심내막염%림상특정%영상학표현%기출질병%병발증
Septic pulmonary embolism%Infective endocarditis%Clinical feature%Imaging%Underlying disease%Complication
目的 提高临床医师对脓毒性肺栓塞的认识及争取早期诊断和治疗.方法 对3例脓毒性肺栓塞病例的临床表现、影像学特征、基础疾病、并发症、实验室检查等方面进行病例分析及文献复习.结果 3例脓毒性肺栓塞均有发热、咳嗽、咯痰等症状.影像学上表现为双肺靠近胸膜处结节状、斑片状阴影等改变,2例伴有空洞,其中1例伴有气囊肿,2例伴有胸腔积液.基础疾病方面3例患者均通过心脏彩色多普勒确诊伴有感染性心内膜炎.并发症方面1例患者出现肾脏、眼底受损,2例患者伴有贫血.血培养仅有1例为阳性.结论 脓毒性肺栓塞是一种少见但严重的疾病,无特征性的临床表现,影像学上常有靠近胸膜多发结节状斑片状影,伴或不伴空洞形成.多有感染性心内膜炎等基础疾病,可出现肾脏、眼底等栓塞并发症,血培养阳性率较低.早期诊断及治疗对提高患者预后具有重要意义.
目的 提高臨床醫師對膿毒性肺栓塞的認識及爭取早期診斷和治療.方法 對3例膿毒性肺栓塞病例的臨床錶現、影像學特徵、基礎疾病、併髮癥、實驗室檢查等方麵進行病例分析及文獻複習.結果 3例膿毒性肺栓塞均有髮熱、咳嗽、咯痰等癥狀.影像學上錶現為雙肺靠近胸膜處結節狀、斑片狀陰影等改變,2例伴有空洞,其中1例伴有氣囊腫,2例伴有胸腔積液.基礎疾病方麵3例患者均通過心髒綵色多普勒確診伴有感染性心內膜炎.併髮癥方麵1例患者齣現腎髒、眼底受損,2例患者伴有貧血.血培養僅有1例為暘性.結論 膿毒性肺栓塞是一種少見但嚴重的疾病,無特徵性的臨床錶現,影像學上常有靠近胸膜多髮結節狀斑片狀影,伴或不伴空洞形成.多有感染性心內膜炎等基礎疾病,可齣現腎髒、眼底等栓塞併髮癥,血培養暘性率較低.早期診斷及治療對提高患者預後具有重要意義.
목적 제고림상의사대농독성폐전새적인식급쟁취조기진단화치료.방법 대3례농독성폐전새병례적림상표현、영상학특정、기출질병、병발증、실험실검사등방면진행병례분석급문헌복습.결과 3례농독성폐전새균유발열、해수、각담등증상.영상학상표현위쌍폐고근흉막처결절상、반편상음영등개변,2례반유공동,기중1례반유기낭종,2례반유흉강적액.기출질병방면3례환자균통과심장채색다보륵학진반유감염성심내막염.병발증방면1례환자출현신장、안저수손,2례환자반유빈혈.혈배양부유1례위양성.결론 농독성폐전새시일충소견단엄중적질병,무특정성적림상표현,영상학상상유고근흉막다발결절상반편상영,반혹불반공동형성.다유감염성심내막염등기출질병,가출현신장、안저등전새병발증,혈배양양성솔교저.조기진단급치료대제고환자예후구유중요의의.
Objective To improve the clinicians' understanding of septic pulmonary embolism (SPE) for early diagnosis and treatment. Methods The clinical manifestations, imaging characteristics, underlying diseases,complications, laboratory tests and others of three patients with SPE were analyzed and related literatures were reviewed. Results Three cases of SPE had fever, cough, and expectoration. The imaging features showed nodous and patchy shadows near the pleura of lung. Cavitations were found in two cases,in one of whom lung cysts were found. Pleural effusions were found in two cases. On the underlying disease, three cases were diagnosed to have infective endocarditis by color Doppler. On the complication,one case had damage of kidney and fundus oculi,two cases had anemia. Only one case had positive blood culture result. Conclusions SPE is a rare but serious disease, and has no characteristic clinical manifestation. The imaging feature is multiple nodous and patchy shadow near the pleura, with or without cavitations. Many patients with SPE may have underlying diseases such as infective endocarditis, and complicate with embolism in kidney and fundus oculi. The positive rate of blood culture is low. Early diagnosis and treatment are important to improve the prognosis of patients.
