百草枯中毒肺损伤治疗前后CT表现特征与预后相关性分析.docVIP

百草枯中毒肺损伤治疗前后CT表现特征与预后相关性分析 　　[摘要] 目的 探讨百草枯中毒所致肺损伤患者在不同剂量、治疗不同时期的CT影像学特征以及临床预后。 方法 选取我院2011～2013年收治的50例百草枯中毒患者，对患者不同剂量、不同治疗分期的CT表征与临床预后进行观察。 结果 患者早期治疗中的主要特征为肺纹理增多、纵隔气肿、磨玻璃征或无明显异常，而中期的主要特征为肺纹理增多、纵隔气肿、磨玻璃征、肺间质纤维化，治疗晚期阶段患者存活患者主要表现为肺间质纤维化。少量组22例患者均好转出院；中量组21例患者中15例好转出院，6例预后不良；大量组患者9例全部死亡。 结论 百草枯中毒患者肺损伤包括肺实质与间质同时受损，以纵隔气肿、磨玻璃征、实质病变、肺气肿与胸腔积液为主，晚期主要表现为间质纤维化，可以明确百草枯中毒肺损伤治疗具有明显的CT表征，且与预后存在明显相关性。 　　[关键词] 百草枯中毒；肺损伤；CT表现特征；预后；相关性分析 　　[中图分类号] R595；R816.4 [文献标识码] B [文章编号] 2095-0616（2013）22-100-03 　　Analysis on correlation between CT features and prognosis of pulmonary injury caused by paraquat poisoning before and after the treatment 　　WU Tianqiong YE Gengxin 　　Department of Radiology， the Twelfth Peoples Hospital of Guangzhou City， Guangzhou 510620， China 　　[Abstract] Objective To investigate the CT features and clinical prognosis of patients with pulmonary injury caused by paraquat poisoning in different doses and treatment periods. Methods Fifty patients with paraquat poisoning were selected in our hospital during 2011 to 2013. The CT features and clinical prognosis of patients in different doses and treatment periods were analyzed. Results The main features of patients in the early stage of treatment was increased lung markings， mediastinal emphysema， ground glass opacity or no obvious abnormality， and the main features in the middle stage of treatment was increased lung markings， mediastinal emphysema， ground glass opacity， pulmonary interstitial fibrosis， and the main features of surviving patients in the advanced stage was pulmonary interstitial fibrosis. Twenty-two patients in the small amount group all improved and discharged； Among 21 patients of the middle amount group， 15 cases improved and discharged， 6 cases had a poor prognosis； Nine patients in the large amount group all died. Conclusion Pulmonary injury caused by paraquat poisoning includes the damage of both pulmonary parenchyma and interstitium， and is mainly to mediastinal emphysema， ground glass opacity， paren