不同类型烧伤患者胸部影像学特点及临床意义
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摘要
目的探讨不同类型烧伤患者的胸部影像学特点及临床意义。方法回顾性分析2016年10月至2018年10月于南阳南石医院影像科行胸部CT检查的79例烧伤患者的胸部影像学资料,探讨不同类型烧伤患者的胸部影像学特点及临床意义。结果大面积单纯体表烧伤患者的胸部影像主要以肺部感染、肺水肿及胸腔和(或)心包积液为主;吸入性损伤患者的胸部影像主要以肺水肿、肺部感染、肺实变或不张为主;肺爆震伤患者的胸部影像除肺栓塞及皮下和(或)纵隔气肿较为少见外,肺水肿、肺部感染、肺实变或不张、皮下和(或)支气管异物、气胸、胸腔和(或)心包积液及肋骨骨折均较为多见,且尤以肺水肿及肺部感染最为多见,表现为病情的复杂性与多样性。结论不同类型烧伤患者的胸部影像具有一定差异,有助于临床医生对病情的判断和掌控,为临床诊疗提供可靠的依据,具有一定的临床意义。
Objective To investigate the characteristics and clinical significance of chest imaging of patients with burns of different types.Methods Retrospective analysis was made on chest imaging data of 79 burn patients, who underwent chest CT examination at the Imaging Department, Nanshi Hospital of Nanyang from October 2016 to October 2018, to explore the characteristics and clinical significance of the images of patients with burns of different types.Results The chest images of patients with large-area simple burns of body surface were manifested by pulmonary infection, pulmonary edema, and pleural and/or pericardial effusion, and the chest images of patients with inhalation injury were manifested by pulmonary edema, pulmonary infection, lung consolidation or atelectasis. For patients with lung blast injury, pulmonary embolism and subcutaneous and/or mediastinal emphysema were rare but pulmonary edema, pulmonary infection, lung consolidation or atelectasis, subcutaneous and/or bronchial foreign bodies, pneumothorax, pleural and/or pericardial effusion and rib fracture were more common, especially pulmonary edema and infections, leading to complex and diverse disease condition.Conclusion The chest images of patients with burns of different types vary to some extent, which has certain clinical significance such as making easier for clinicians to judge and control the disease and providing a reliable basis for clinical diagnosis and treatment.
Objective To investigate the characteristics and clinical significance of chest imaging of patients with burns of different types.Methods Retrospective analysis was made on chest imaging data of 79 burn patients, who underwent chest CT examination at the Imaging Department, Nanshi Hospital of Nanyang from October 2016 to October 2018, to explore the characteristics and clinical significance of the images of patients with burns of different types.Results The chest images of patients with large-area simple burns of body surface were manifested by pulmonary infection, pulmonary edema, and pleural and/or pericardial effusion, and the chest images of patients with inhalation injury were manifested by pulmonary edema, pulmonary infection, lung consolidation or atelectasis. For patients with lung blast injury, pulmonary embolism and subcutaneous and/or mediastinal emphysema were rare but pulmonary edema, pulmonary infection, lung consolidation or atelectasis, subcutaneous and/or bronchial foreign bodies, pneumothorax, pleural and/or pericardial effusion and rib fracture were more common, especially pulmonary edema and infections, leading to complex and diverse disease condition.Conclusion The chest images of patients with burns of different types vary to some extent, which has certain clinical significance such as making easier for clinicians to judge and control the disease and providing a reliable basis for clinical diagnosis and treatment.
引文
[1]杨翠,张功艳.重症监护室肺部感染细菌学调查分析[J].中国卫生产业, 2016, 13(36):13-15, 18.
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[4]中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组.肺血栓栓塞症诊治与预防指南[J].中华医学杂志, 2018, 98(14):1060-1087.
[5]赵凤德,孙伟,韩明锋,等.火药爆炸特重度烧伤合并肺冲击伤、吸入性肺损伤临床诊治的初步探讨[J].安徽医学,2007, 28(6):504-505.
[6]中国老年医学学会烧创伤分会.吸入性损伤临床诊疗全国专家共识(2018版)[J].中华烧伤杂志, 2018, 34(11):770-775.
[7]汪丽娅,龚洪翰,郭光华,等.犬蒸气吸入性损伤的实验研究———CT表现与病理对照[J].江西医学院学报, 2000, 40(4):132-134.
[8]贾俐聪,赵杰,谢莉娜,等.大面积烧伤合并吸入性肺损伤的影像分析[J].河北医药, 2010, 32(10):1265-1266.
[9] Horrocks CL. Blast injuries:biophysics, pathophysiology and man?agement principles[J]. J R Army Med Corps, 2001, 147(1):28-40.
[10]陈松林,易云峰,陈检明,等.胸部爆震伤的临床特点和救治分析[J].创伤外科杂志, 2018, 20(7):495-498, 506.
[2]黄培,郭世燕,兰秋燕,等.肺栓塞患者155例临床特点分析[J].疑难病杂志, 2017, 16(2):189-192.
[3]张晓琴,廖健,王敏,等.实验性急性肺栓塞双源CT双能量肺灌注成像与CTPA的对照研究[J]. CT理论与应用研究,2017, 26(2):147-155.
[4]中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组.肺血栓栓塞症诊治与预防指南[J].中华医学杂志, 2018, 98(14):1060-1087.
[5]赵凤德,孙伟,韩明锋,等.火药爆炸特重度烧伤合并肺冲击伤、吸入性肺损伤临床诊治的初步探讨[J].安徽医学,2007, 28(6):504-505.
[6]中国老年医学学会烧创伤分会.吸入性损伤临床诊疗全国专家共识(2018版)[J].中华烧伤杂志, 2018, 34(11):770-775.
[7]汪丽娅,龚洪翰,郭光华,等.犬蒸气吸入性损伤的实验研究———CT表现与病理对照[J].江西医学院学报, 2000, 40(4):132-134.
[8]贾俐聪,赵杰,谢莉娜,等.大面积烧伤合并吸入性肺损伤的影像分析[J].河北医药, 2010, 32(10):1265-1266.
[9] Horrocks CL. Blast injuries:biophysics, pathophysiology and man?agement principles[J]. J R Army Med Corps, 2001, 147(1):28-40.
[10]陈松林,易云峰,陈检明,等.胸部爆震伤的临床特点和救治分析[J].创伤外科杂志, 2018, 20(7):495-498, 506.