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目的探讨急性硫化氢中毒患者的胸部CT表现。方法回顾性分析确诊的58例急性硫化氢中毒患者的临床资料和胸部CT资料,按职业性急性硫化氢中毒诊断标准分成轻度、中度、重度三组。结果轻度30例(51.72%),表现为肺纹理稍增粗或正常,其中少量胸腔积液2例。中度20例(34.48%),表现为主要位于两肺下叶磨玻璃影,部分可见斑片状实变、模糊的小叶中心结节及间质改变。重度8例(13.80%),7例表现为中央型肺水肿,1例表现为弥漫性肺泡性肺水肿。治疗3~5天后复查,病灶大部分吸收,重度组病灶吸收较慢。结论急性硫化氢中毒致化学性肺炎的胸部影像以小斑片状及大片状高密度影为主,病变以两肺下叶为主,重度者可致中央型肺水肿或肺泡性肺水肿。
Objective To investigate the chest CT findings in patients with acute hydrogen sulfide poisoning. Methods A retrospective analysis of 58 cases of acute hydrogen sulfide poisoning in patients with clinical data and chest CT data, according to the diagnostic criteria for occupational acute hydrogen sulfide into mild, moderate and severe three groups. The results were mild in 30 cases (51.72%), manifested as slightly thicker or normal lung texture, a small amount of pleural effusion in 2 cases. Moderate in 20 cases (34.48%), showed mainly in the two lungs under the glass leaf shadow mill, partially visible patchy consolidation, fuzzy lobular center nodules and interstitial changes. Severe in 8 cases (13.80%), 7 cases showed central pulmonary edema, 1 case showed diffuse alveolar pulmonary edema. Treated 3 to 5 days after the review, the majority of lesions were absorbed, severe lesions absorbed slowly. Conclusions Acute hydrogen sulfide poisoning caused by chemical pneumonitis in the chest image with small patchy and large high-density film-based, lesion in the lower lobe of both lungs, severe pulmonary central or pulmonary alveolar pulmonary edema.