摘要
目的研究重症肺炎合并肺部感染患者胸部CT征象及其诊断价值。方法回顾性分析2018年6月至2019年6月我院收治的60例重症肺炎合并肺部感染患者的临床资料,根据不同的检查方法分为观察组(n=30)和对照组(n=30),观察组采用常规实验室检查联合胸部CT检查,对照组采用胸部X线检查,对比两组肺部感染诊断阳性率和不同病原菌所致肺部感染的CT影像特征。结果观察组诊断阳性率为90.00%,对照组诊断阳性率为53.33%,两组比较差异具有统计学意义(P<0.05)。观察组20例患者表现为片状、斑片状实变影,其中伴空洞影4例,2例出现肺气囊,4例出现肺纹理模糊伴毛玻璃样影;对照组主要表现为肺内炎性浸润,3例出现空洞影。肺部感染患者痰培养病原菌主要以铜绿假单细胞菌、金黄色葡萄球菌及肺炎克雷伯杆菌为主。其中铜绿假单细胞肺炎主要表现为肺部局部实变型和肺脓肿,本研究出现8例,4例空洞影;金黄色葡萄球菌主要表现为肺实质呈炎症性浸润改变,且大多数呈大片增密模糊影,少数呈阶段或大叶性浸润,同时出现肺气囊,本研究中2例患者均伴有肺气囊影;克雷伯杆菌主要表现为双肺上下叶后段呈小叶浸润,叶间裂呈呈弧形影,本研究中4例。结论胸部CT可提高重症肺炎合并肺部感染患者早期肺部感染的准确率,减少漏诊和误诊,值得临床进一步推广。
Objective To study the chest CT signs and diagnostic value of severe pneumonia with pulmonary infection.Methods the clinical data of 60 patients with severe pneumonia complicated with pulmonary infection admitted to our hospital from June 2018 to June 2019 were retrospectively analyzed.According to different examination methods,they were divided into observation groups(n=30)and control groups(n=30).the observation group was given routine laboratory examination combined with chest CT examination,and the control group was given chest X-ray examination.the positive rate of diagnosis of pulmonary infection and different pathogens were compared between the two groups.CT imaging features of pulmonary infection.results the positive rate of diagnosis was 90.00%in the observation group and 53.33%in the control group.there was a significant difference between the two groups(P<0.05).In the observation group,20 patients showed patchy and patchy solid shadows,including 4 with cavity shadows,2 with air bag,4 with blurred lung texture,and ground glass shadows;in the control group,the main manifestations were inflammatory infiltration in the lung,and 3 with cavity shadows.the main pathogens in sputum culture of patients with pulmonary infection were Pseudomonas aeruginosa,Staphylococcus aureus,and Klebsiella pneumoniae.the main manifestations of Pseudomonas aeruginosa pneumonia were local pulmonary consolidation and pulmonary abscess.there were 8 cases and 4 cases of empty shadow in this group.Staphylococcus aureus mainly showed inflammatory infiltration of the lung parenchyma,and most of them showed large dense and blurred shadows,a few showed stage or lobar infiltration,and at the same time,there was a pulmonary balloon.Klebsiella was the main manifestation in 2 patients in this group.the manifestations were lobular infiltration in the posterior segment of upper and lower lobes of both lungs and arc-shaped interlobar fissures in 4 cases.Conclusion thoracic CT can improve the accuracy of early pulmonary infection in patients with severe pneumonia complicated with pulmonary infection,reduce missed diagnosis and misdiagnosis,and is worthy of further clinical promotion.
作者
贾明雅
郑喜胜
董照刚
李长力
白斌
JIA Ming-ya;ZHENG Xi-sheng;DONG Zhao-gang;LI Chang-li;BAI Bin(Department of Critical Care Medicine,The Central Hospital of Nanyang City,Nanyang 473000,Henan Province,China)
出处
《中国CT和MRI杂志》
2021年第5期33-34,共2页
Chinese Journal of CT and MRI
关键词
重症肺炎合并肺部感染
胸部CT征象
诊断价值
Severe Pneumonia with Pulmonary Infection
Chest CT Signs
Diagnostic Value
