CAJ | 학술논문

目的探讨急性氯气中毒患者胸部X线和CT表现及诊断价值.方法对南京军区南京总医院28例氯气中毒患者发病后一系列胸部X线和CT表现进行回顾性比较分析.结果 X线表现:9例胸片正常;2例首诊胸片正常,1～2 d后见异常.17例首诊X线表现异常:急性气管-支气管周围炎3例,急性化学性支气管肺炎6例,弥漫性间质性肺水肿和中央性肺水肿为8例.CT表现:发病1～3 d,轻者两肺散在斑点状致密影;中重度者为多发斑片状或弥漫性渗出,部分融合实变,见空气支气管征及胸腔积液.发病4～10 d,轻者基本吸收,中重度者斑片状渗出影吸收变淡,两肺实变面积缩小.发病10 d后,4例完全恢复正常,6例30～40 d时表现为肺内少许纤维条索影,1例42 d时表现为两肺内细小点状模糊影,呈较淡毛玻璃样改变.结论急性氯气中毒因病变程度不同可表现为急性支气管-肺炎和急性肺水肿的影像改变,一系列胸部X线检查有助于掌握病情的动态变化,CT检查能较准确地评价肺部病变.
목적 탐토급성록기중독환자흉부X선화CT표현급진단개치.방법 대남경군구남경총의원28례록기중독환자발병후일계렬흉부X선화CT표현진행회고성비교분석.결과 X선표현:9례흉편정상;2례수진흉편정상,1～2 d후견이상.17례수진X선표현이상:급성기관-지기관주위염3례,급성화학성지기관폐염6례,미만성간질성폐수종화중앙성폐수종위8례.CT표현:발병1～3 d,경자량폐산재반점상치밀영;중중도자위다발반편상혹미만성삼출,부분융합실변,견공기지기관정급흉강적액.발병4～10 d,경자기본흡수,중중도자반편상삼출영흡수변담,량폐실변면적축소.발병10 d후,4례완전회복정상,6례30～40 d시표현위폐내소허섬유조색영,1례42 d시표현위량폐내세소점상모호영,정교담모파리양개변.결론 급성록기중독인병변정도불동가표현위급성지기관-폐염화급성폐수종적영상개변,일계렬흉부X선검사유조우장악병정적동태변화,CT검사능교준학지평개폐부병변.
Objective To investigate the radiographic and computerized tomographic features of chest in patients with acute chlorine poisoning and its diagnostic value.Methods Twenty-eight cases of chlorine poisoning were reviewed.And their radiographic and computerized tomographic features were compared and analyzed.Results Radiographic findings: Among 28 patients, 9 cases were normal and 2 cases had no abnormalities on the first chest X-ray and became abnormal one or two days later.And there were abnormal findings in first chest X-ray in 17 patients: acute tracheal inflammation of peribronchitis (n = 3), acute chemical bronchopneumonia(n = 6)and diffuse interstitial and central pulmonary edema (n = 8).CT manifestations: At Days 1-3, the patients of mild poisoning had scattered patchy dense shadow;those of moderate to severe poisoning showed multiple patchy or diffuse infiltration(ground-glass opacity).And partial consolidation, air bronchogram and pleural effusion could be observed.At Days 4-10, the manifestations of mild poisoning were largely absorbed;those of moderate to severe poisoning manifested the absorption of diffuse or multiple patchy effusion and a fading of shadow.And the size of lung consolidation became smaller than before.At Day 10 after onset, 4 patients completely recovered.At Days 30-40, 6 cases showed traces of fibrous shadow and one case showed small punctiform opacities in both lungs.And at Day 42, there was slight ground-glass change.Conclusion Acute chlorine gas poisoning in varying degrees may manifest acute bronchial pneumonia and acute pulmonary edema.During treatment, a series of chest X-ray examinations will help to follow the changes of disease.And CT examination can offer a more accurate evaluation of lung lesions.