新型冠状病毒感染引起的肺间质病变诊断和治疗专家建议.pdfVIP

新型冠状病毒感染引起的肺间质病变诊断 和治疗专家建议 中国研究型医院学会呼吸病学专业委员会 北京中西医结合学会呼吸病分会 通信作者：徐作军，Email：xuzj@ 【摘要】 新型冠状病毒肺炎（COVID‑19）是一种急性感染性肺炎，其病原体为2019新型冠状病毒 （SARS‑CoV2）。自2019年12月以来，全国确诊感染病例数超过8万例。COVID‑19在影像学上表现为 双肺间质性炎症，约30%~60%的患者出现不同程度的肺间质改变，但大部分患者预后良好。对于如 何处理COVID‑19引起的肺间质病变方面临床较为困惑，为此我们邀请国内间质性肺疾病领域专家制 定了本建议，旨在为国内同道处理COVID‑19引起的肺间质病变时提供参考意见。由于目前疫情发生 时间短，临床资料和相关研究数据尚不充分，今后将会根据最新的研究结果对本建议进行相应更新。 基金项目：国家重点研发计划精准医学研究重点专项（2016YFC0905700） Expert recommendations for the diagnosis and treatment of interstitial lung disease caused by novel coronavirus pneumonia Chinese Research Hospital Association, Respiratory Council; Beijing Association of the Integrating of Traditional and Western Medicine, Society of Respiratory Diseases Corresponding author: Xu Zuojun, Email: xuzj@ 【Abstract 】 COVID‐19 is an acute infectious disease caused by a newly discovered coronavirus (SARS‐CoV2). COVID‐19 may manifest bilateral interstitial pneumonia on imaging. About 30%-60% of patients present varying degrees of interstitial changes, while most patients have a good prognosis. Since there′s little practical instruct on treating interstitial lung disease (ILD) causedbyCOVID‐19, we present this file as references for all the colleagues fighting with this disease. The primary findings on CT are bilateral, peripheralground‐glassopacities (GGO) and consolidation. Inter‐/intra‐lobularseptalthickeningarealsocommon. Subpleural lines and traction bronchiectasis can be seen in some cases which indicate the presence of interstitial fibrosis. Images of severe cases are similar with those in advanced stage of nonspecific interstitial pneumonia (NSIP) and organizing pneumonia (OP). COVID‐19 could present the typical two phases of diffuse alveolar damage: acute and proliferative phase on pathology. Massive pulmonary interstitial fibrosis may also be present. HRCT is the best radiological approach for the diagnosis