修翻译7年呼吸TB3.pptVIP

呼吸系统影像诊断学 Imaging diagnostics of the Respiratory system 郑州大学第一附属医院放射科 the first affiliated hospital radiology department of the Zhengzhou University 张焱 Zhang Yan （四）肺结核 Pulmonary tuberculosis: 1.临床特点：clinical characters （1）病原：pathogeny 人或牛结核杆菌 Bacillus tuberculosis or Bacillus tuberculosis bovis （2）病理：pathology ①结核菌侵入人体后引起的基本病理变化为: basic pathological change caused by tuberculosis 渗出及增殖 exudation and proliferation ②机体抵抗力低下时，病变则出现: pathological change of low resistance 干酪样坏死，液化及空洞形成caseous necrosis, colliquation and porosis. ③机体抵抗力强或经适当治疗后病灶： pathological change of low resistance or post –treatment 吸收 absorption 纤维化 fibrosis 钙化 calcification 空洞瘢痕闭合或净化空洞 cavity close or asepsis cavity （3）分期: stages ①进展期：progression 新发现病灶，病灶扩大 new lesion and expansion 病灶边界变模糊 obscure border 出现空洞或空洞增大，痰结核菌阳性 cavity appearance or expansion,spit positive ②好转期：resolving stage 病灶缩小，边界变清楚，病灶消失 clarity of border and lessening or disppearance of lesion 空洞缩小或消失 lessen or disappear of nidus 痰结核菌转阴性（连续3月，1次/月） spit negative (3 months continous,1time/month) ③稳定期：stationary stage 病灶无活动 lesion inactivity，空洞闭合cavity close up，痰结核菌连续6个月阴性（至少1次/月） spit negative (6 months continus,1time/month) 如有空洞，连续1年以上阴性，属临床治愈 spit negative continous more than 1 year is clinical cure if the cavity exsist 再经观察2年仍无活动，结核菌仍阴性 focus inactivity for more 2 years and spit negative continous 如有空洞，需观察3年以上为临床痊愈 clinical cure should be observe for 3 years if the cavity exist 2.影像表现： 1978年全国结核病防治会议natinal conference for cure and prevetion of tuberculosis分为五个类型： Ⅰ型 type： 原发性肺结核primary pulmonary tuberculosis（原发综合征primary syndrome，胸内淋巴结核intrathoracic scrofula） Ⅱ型type ： 血行播散型肺结核hematogenous pulmonary tuberculosis（急性粟粒型肺结核acute military tuberculosis，亚急性或慢性血行播散型肺结核subacute or chronic hematogenous pulmonary tuberculosis） Ⅲ型 ： 浸润型肺结核（含结核瘤和干酪肺炎） exudative pulmonary tuberculosis(tuberculoma and caseous pneumonia) Ⅳ型： 慢性纤维空洞型肺结核 chronic fibro-cavernous pulmonary tuberculosis Ⅴ型 ： 胸膜炎型肺结核 tuberculous pleurisy