摘要
目的分析外源性类脂性肺炎病例的诊治特点,提高临床医师对该类少见疾病的认识,以提高治愈率及降低误诊率。方法回顾性分析2018年1月至2021年1月重庆市涪陵中心医院呼吸科收治的8例确诊外源性类脂性肺炎患者的临床资料,分析患者的临床表现、影像学表现、实验室检查指标、随访情况。结果该病多见于男性,常有油脂类物质接触史,以咳嗽、胸痛、咳痰等为主要临床表现,胸部影像学常以右肺中叶及双肺下叶病变为主,病变性质以感染病变多见。发病早期常有白细胞、中性粒细胞、单核细胞、CRP、血沉、超敏C反应蛋白等指标增高,经常规抗感染及静脉激素抗炎治疗,病变可完全吸收,短期随访预后良好。结论外源性类脂性肺炎需详细询问并获得有油脂类物质误吸史,结合临床表现及影像学改变可做出诊断,可依据病理及气管镜灌洗液查见大量吞噬油脂的巨噬细胞最终确诊。通过内科保守治疗及支气管镜灌洗等治疗可缓解该病,治疗无效者可考虑外科手术治疗。
Objective To analyze the diagnosis and treatment characteristics of exogenous lipoid pneumonia cases,improve clinicians'under-standing of this rare disease,and improve cure rate and reduce misdiagnosis rate.Methods The clinical data of 8 patients diagnosed with exoge-nous lipoid pneumonia were retrospectively analyzed in the Department of Respiratory Medicine,Fuling Central Hospital of Chongqing City from January 2018 to January 2021,and analyze the patient's clinical manifestations,imaging manifestations,laboratory test indicators,and follow-up sta-tus.Results This kind of disease was more common in men,with a history of exposure to oils and fats.The main clinical manifestations were cough,chest pain,and sputum.Chest imaging was usually based on the lesions of the right middle lobe and the lower lungs.Infectious lesions were more common.In the early stage of the disease,white blood cells,neutrophils,monocytes,CRP,erythrocyte sedimentation rate,hypersensitive C-re-active protein and other indicators were often increased.The lesions could be completely absorbed by conventional anti-infection and intravenous hormone anti-inflammatory treatment,and the prognosis was good after short-term follow-up.Conclusion Exogenous lipid pneumonia requires de-tailed inquiries and a history of oily substance aspiration.A diagnosis can be made in combination with clinical manifestations and imaging changes.The final diagnosis can be confirmed based on pathology and bronchoscopy lavage fluid to find a large number of macrophages that eat fat.The dis-ease can often be alleviated by medical conservative treatment and bronchoscopy lavage and other treatments.If treatment fails,surgical treatment may be considered.
作者
何林
李小明
朱小华
HE Lin;LI Xiaoming;ZHU Xiaohua(Department of Respiratory and Critical Care Medicine,Fuling Central Hospital of Chongqing City,Chongqing,408000,China)
出处
《当代医学》
2021年第20期114-116,共3页
Contemporary Medicine
