儿童肺炎支原体肺炎与肺炎支原体合并链球菌感染肺炎的胸部CT鉴别诊断研究

发布时间：2018-10-30 13:02

【摘要】：目的探讨儿童肺炎支原体肺炎与肺炎支原体合并链球菌感染肺炎的胸部CT表现及其鉴别,为该病的临床诊治提供参考。方法选取2013年11月-2015年11月医院收治的肺炎患儿74例,根据血清MP-IgM检测以及链球菌血培养的结果,将32例单纯肺炎支原体肺炎的患儿分为A组,将42例肺炎支原体合并链球菌感染肺炎的患儿分为B组,对比两组患儿胸部CT检查中气道和肺间质病变征象的出现率;对比两组患儿的胸腔积液量以及肿大淋巴结的体积;对比两组患儿的肺内病变形态。结果 A组患儿胸部CT出现磨玻璃影、网状影、支气管壁增厚、支气管血管束增厚的比例均显著高于B组(P0.05);B组患儿出现胸腔积液的有24例占57.14%,显著高于A组(P0.05);B组患儿胸腔积液的厚度为(14.63±12.57)mm,显著大于A组(P0.05);B组肿大淋巴结的最大横径为(11.29±3.26)mm,显著大于A组(P0.05);A组肺内病变形态为扇形薄片影的有24例占75.00%,显著多于B组(P0.05);B组肺内病变形态为无规律肺内实变影的有37例占88.10%,显著多于A组(P0.05)。结论单纯肺炎支原体肺炎胸部CT像以肺间质改变为主;合并肺炎链球菌感染时,CT像表现出肺泡炎症反应的肺内片状阴影,且胸腔积液和淋巴结肿大更为明显。
[Abstract]:Objective to investigate the chest CT manifestations of mycoplasma pneumoniae pneumonia and mycoplasma pneumoniae combined with streptococcus pneumoniae infection in children and to provide reference for clinical diagnosis and treatment of the disease. Methods from November 2013 to November 2015, 74 children with pneumonia were selected. According to the results of serum MP-IgM detection and streptococcus blood culture, 32 children with mycoplasma pneumoniae pneumonia were divided into group A, group A and group A, respectively. 42 cases of mycoplasma pneumoniae combined with streptococcal pneumonia were divided into group B, and the incidence of airway and pulmonary interstitial lesions in chest CT was compared between the two groups. The amount of pleural effusion and the volume of enlarged lymph nodes were compared between the two groups. Results the proportion of CT in group A was significantly higher than that in group B (P0.05). There were 24 cases of pleural effusion in group B (57.14%), which was significantly higher than that in group A (P0.05). The thickness of pleural effusion in); B group was (14.63 卤12.57) mm, significantly higher than that in group A (P0.05). The maximum transverse diameter of enlarged lymph nodes in group B was (11.29 卤3.26) mm, significantly larger than that in group A (P0.05). In group B, 24 cases (75.00%) had fan-shaped thin slice shadow of lung lesions, which was significantly higher than that in group B (P0.05). There were 37 cases (88.10%) with irregular intrapulmonary consolidation in group B, which was significantly more than that in group A (P0.05). Conclusion Pulmonary interstitial changes are dominant in chest CT images of mycoplasma pneumoniae pneumonia, while in cases of Streptococcus pneumoniae infection, CT images show flaky shadows of alveolar inflammation, and pleural effusion and lymphadenopathy are more obvious.
【作者单位】：安阳市人民医院放射科;
【分类号】：R725.6

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