CAJ | 학술논문

目的探讨临床拟诊机化性肺炎的诊断与治疗.方法回顾性分析31例临床拟诊为机化性肺炎患者的临床资料、影像资料和治疗方法.结果 31例经抗生素治疗无效的患者,通过支气管镜肺活检病理或经皮肺穿刺病理除外结核、真菌、化脓性炎、肺癌而拟诊机化性肺炎24例,无病理检查结果而经激素治疗有效拟诊7例.21例患者具有典型机化性肺炎CT表现,所有病例均经短期(6～14d)激素治疗后影像学结果明显改善.随访6～25个月,复发6例,均发生在激素减量过快或停药患者中.结论临床上经抗生素治疗无效、结合临床影像学特点、病理检查除外其他疾病是拟诊机化性肺炎的重要指标;对于无病理检查患者短期激素治疗有效有助于诊断.过早激素减量容易导致复发.
목적 탐토림상의진궤화성폐염적진단여치료.방법 회고성분석31례림상의진위궤화성폐염환자적림상자료、영상자료화치료방법.결과 31례경항생소치료무효적환자,통과지기관경폐활검병리혹경피폐천자병리제외결핵、진균、화농성염、폐암이의진궤화성폐염24례,무병리검사결과이경격소치료유효의진7례.21례환자구유전형궤화성폐염CT표현,소유병례균경단기(6～14d)격소치료후영상학결과명현개선.수방6～25개월,복발6례,균발생재격소감량과쾌혹정약환자중.결론 림상상경항생소치료무효、결합림상영상학특점、병리검사제외기타질병시의진궤화성폐염적중요지표;대우무병리검사환자단기격소치료유효유조우진단.과조격소감량용역도치복발.
Objective To explore the diagnosis and treatment of clinical possible organizing pneumonia.Methods The medical records of 31 patients with clinical probable organizing pneumonia were retrospectively analyzed.The clinical presentation,radiographic results and treatment were collected and analyzed.Results Thirty-one patients with non-response to antibiotics were preliminary diagnosed as organizing pneumonia.By percutaneous lung biopsy or transbronchial lung biopsy the tuberculosis,fungi,suppurative inflammation,lung cancer and other diseases were ruled out in 24 patients,and 7 patients were diagnosed by perfect effect of corticosteroids treatment.Twenty-one patients had typical CT findings.All the patients responded rapidly and completely to the administration of corticosteroids.Six patients relapsed after the reduction or stop of corticosteroid in a follow-up time of 6-25 months.Conclusions Non-response to antibiotics,the typical imaging findings and lung biopsy ruling out other diseases are important for diagnosing organizing pneumonia.Rapid response to administration of corticosteroids may be helpful to the diagnosis.Decreasing the dose of corticosteroid too early may cause recurrence of organizing pneumonia.