论文部分内容阅读
目的 分析严重急性呼吸道综合征 (Severacuterespiratorysyndrome ,SARS)患者X线表现和变化规律。方法 使用SPASS11.0及SDAS软件回顾性分析 3 3 0例临床确诊的SARS患者 ,对病后的一系列X线胸片和高清晰度CT(HRCT)影像进行分析。结果 ① 2 1.5 %的患者入院时X线胸片检查无明确炎性改变 ,90 %SARS患者在 1周内X线胸片出现局造性斑片状模糊影 ,2周内达高峰 ,肺部存在阴影者仅 98 8%,另有 1.2 %的患者始终没有X线胸片改变 ,但CT有改变 ,80 %的患者在 5周内康复。②急性期胸部X线绝大多数以肺实质性病变为主 ,形态多样 ,双肺同时受累率高 (初期47%,最重时 5 9 5 %)为其特点。③轻型SARS以一个肺叶病变为主 ( 5 3 %) ,多为周边型 ( 5 3 1%) ,吸收好 ,恢复快 ;重型SARS多以二个或二个以上肺叶病变为主 ( 70 3 %) ,多为中央或混合型 ( 71 8%) ,其中混合型占 5 0 %,间质性损害为主 ,吸收慢预后差。④ 45例恢复期患者的HRCT检查 ,71.2 %留有肺间质改变。结论 SARS患者早期可出现多种X线胸片炎性改变 ,双肺同时受累率高 ,尤以中央型或混合型重症比例高 ,发展快 ,预后差 ;对于疑似患者提倡早期行HRCT检查
Objective To analyze the X-ray findings and changes of patients with Severe Acute Respiratory Syndrome (SARS). Methods A retrospective analysis of 303 cases of SARS patients with SPASS11.0 and SDAS software was performed to analyze a series of X-ray and high-resolution CT (HRCT) images after the illness. Results ① There were no definite inflammatory changes in 1.5% of the patients on X-ray examination at admission. In 90% of SARS patients, focal plaque-like blur appeared on X-ray in 1 week, peaked in 2 weeks, There were only 98.8% of the shadows, and 1.2% of the patients had no X-ray changes at all, but CT had changed and 80% recovered within 5 weeks. ② In the acute stage, the majority of chest X-ray was mainly pulmonary parenchymal lesions, with various shapes and characteristics of both lungs being affected at the same time (initial 47% and heaviest 559%). (3) Most of the patients with severe acute respiratory syndrome (SARS) had one lung lesion (53%), mostly peripheral type (51.3%), ), Mostly central or mixed (71.8%), of which mixed accounted for 50% of the main interstitial damage, slow absorption of poor prognosis. 45 patients with convalescent HRCT examination, 71.2% left lung interstitial changes. Conclusions There are many kinds of X-ray changes in the early stage of SARS. The incidence of both lungs is high at the same time. Especially in the central or mixed type, the proportion of severe cases is high, the development is rapid and the prognosis is poor. For the suspected patients, HRCT