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目的探讨儿童麻疹肺部感染两种类型的影像学表现,提高和重视对这一疾病的认识和诊断水平。方法回顾分析82例儿童麻疹肺部感染的影像学表现,结合临床资料等,将肺部感染分为麻疹肺炎和麻疹合并肺炎两种类型,并就两种感染类型的CRP和PCT等检验指标进行统计学分析。结果 (1)麻疹肺炎(50例)。X线胸片:肺气肿31例,肺纹理增多、模糊39例,肺门增大8例,磨玻璃影2例,典型麻疹肺炎22例。CT扫描8例,3例表现为两下肺散在点片状模糊影,1例表现为左舌叶小片状影伴左侧胸膜增厚,1例为右上肺及左下肺的小片状影,其余3例CT检查正常。(2)麻疹合并肺炎(32例)。X线胸片:两肺纹理增多、模糊20例,肺门增大4例,小叶性麻疹合并肺炎9例,多肺段或大叶性肺实变23例,磨玻璃影4例,气胸及纵隔皮下气肿3例。CT扫描7例,包括两肺多发片絮状影3例,两肺大片状实变影4例,伴发磨玻璃影4例,气胸及纵隔皮下气肿3例,其中1例合并心包积气。(3)采用Mann-Whitney U检验,结果显示,CRP在麻疹肺炎与麻疹合并肺炎、典型麻疹肺炎与小叶性麻疹合并肺炎之间指标Z差异无统计学意义。PCT在麻疹肺炎与麻疹合并肺炎、典型麻疹肺炎与小叶性麻疹合并肺炎之间指标Z差异有统计学意义(P<0.001)。结论儿童麻疹肺部感染两种类型的影像学表现具有一定的特征,结合CRP及PCT等检验指标分析,有助于提高对两者的认识和鉴别水平。对于提高诊断水平和指导临床治疗及疗效评估有重要意义。
Objective To explore two types of imaging manifestations of measles and lung infection in children and to raise awareness of and diagnosis of the disease. Methods A retrospective analysis of 82 cases of children with measles pulmonary infection imaging findings, combined with clinical data, the lung infection is divided into two types of measles and measles with pneumonia, and two types of infection CRP and PCT and other test indicators Statistical analysis. Results (1) Measles pneumonia (50 cases). X-ray: 31 cases of emphysema, increased lung markings, blurred 39 cases, hilar augmentation in 8 cases, ground glass in 2 cases, 22 cases of typical measles pneumonia. CT scan in 8 cases, 3 cases manifested as two lung scattered spot fuzzy film, 1 case showed left lingual flap with left pleural thickening, 1 case of right upper lung and left lower lung , The remaining three cases of CT examination was normal. (2) Measles with pneumonia (32 cases). X-ray: two lungs increased texture, fuzzy 20 cases, 4 cases of hilar enlargement, lobular measles with pneumonia in 9 cases, multiple lung segment or lobar lung consolidation in 23 cases, ground glass in 4 cases, pneumothorax and Mediastinal subcutaneous emphysema in 3 cases. CT scans in 7 cases, including two lung multiple flakes in 3 cases, two lungs massive real change in 4 cases, associated with ground glass in 4 cases, pneumothorax and mediastinal subcutaneous emphysema in 3 cases, of which 1 case with pericardial gas. (3) The Mann-Whitney U test showed that there was no significant difference in the index Z between CRP and measles pneumonia and measles complicated with pneumonia, and typical measles pneumonia and lobular measles with pneumonia. There was significant difference in index Z between measles-pneumonia and measles-associated pneumonia, typical measles pneumonia and lobular measles with pneumonia (P <0.001). Conclusion The two types of imaging manifestations of childhood measles and lung infection have certain characteristics. Combined with the analysis of CRP and PCT test indexes, it is helpful to improve the level of understanding and discrimination of both. For improving the diagnostic level and guiding the clinical treatment and efficacy evaluation of great significance.