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通过对16例放射性肺损伤资料的总结,讨论了照射剂量、照射野面积等因素与肺放射性损伤的发生及时间的关系,分析了肺损伤X线改变的动态表现,认为:(1)放射性肺损伤与放疗剂量及照射野面积关系密切,照射野面积大,能产生肺损伤的剂量相对就小。(2)急性放射性肺损伤多在放疗后1个月内出现;慢性肺纤维化平均在放疗后4.23个月出现,半年内纤维化发生率约为85.7％。(3)肺损伤的临床表现与X线征象不平行,临床表现程度一般较X线征象轻。此外,依据放射性肺损伤的X线表现及动态发展,还对肺损伤与肿瘤的间质性肺转移、普通肺炎及肿瘤放疗后复发的鉴别诊断进行了分析。
By summarizing the data of 16 cases of radiation-induced lung injury, the relationship between the radiation dose and the radiation field area and the occurrence and time of lung radiation injury was discussed. The dynamic manifestation of X-ray changes of lung injury was analyzed. It was considered that: (1) Radiation lung The injury is closely related to the dose of radiation therapy and the area of the radiation field. The radiation field has a large area and the dose of lung injury can be relatively small. (2) Acute radiation-induced lung injury occurred more than one month after radiotherapy; chronic pulmonary fibrosis occurred on average 4.23 months after radiotherapy, and the incidence of fibrosis was approximately 85.7% within six months. (3) The clinical manifestations of lung injury and X-ray signs are not parallel, and the clinical manifestations are generally lighter than X-ray signs. In addition, based on the X-ray manifestation and dynamic development of radiation lung injury, the differential diagnosis between lung injury and tumor interstitial lung metastasis, common pneumonia, and recurrence after radiotherapy was analyzed.