在血液肿瘤患者肺部侵袭性真菌感染中CT影像学检查的诊断价值

发布时间：2018-02-25 17:31

本文关键词： CT影像学检查血液肿瘤肺部侵袭性真菌感染诊断价值　出处：《中华医院感染学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的研究CT影像学检查在血液肿瘤患者发生肺部侵袭性真菌感染的诊断价值。方法选取2012年1月-2016年5月选择医院接诊的68例血液肿瘤患者,所有患者采用CT影像学进行检查。分析X线胸片诊断与CT诊断发生肺部侵袭性真菌感染率比较、肺部真菌感染类型、病原菌分布构成比、患者的CT影像学特征表现。结果 35例患者发生肺部侵袭性真菌感染,感染率为51.47%;肺部真菌感染患者经CT影像学检测,肺部真菌感染的类型主要有弥漫型、曲菌球型、实变型和结节型,分别占37.14%、25.71%、22.86%和14.29%;35例患者按照《全国临床检查操作规程》进行病原学诊断,均呈现阳性,阳性率为100.00%;X线胸片诊断8例呈阳性,阳性率22.85%;CT影像诊断31例,阳性率88.57%,CT影像诊断阳性率明显高于X线胸片诊断,两组比较差异有统计学意义(P0.05);病原菌分布主要是以曲霉菌属为主,其次为假丝酵母菌属、隐球酵母菌属;CT影像学特征包括结节或肿块影、晕征、空洞。结论 CT影像学检查在肺部侵袭性真菌感染的诊断具有非常重要的意义,能够提供有效的诊断依据,特别是在肺部真菌感染的早期治疗中,结合患者临床的基础疾病,可以初步的诊断肺部真菌感染,具有良好的临床参考价值,值得在临床上广泛推广。
[Abstract]:Objective to study the CT imaging examination in patients with hematological malignancy incidence of pulmonary invasive fungal infections diagnostic value. Methods from January 2012 -2016 year in May 68 cases of patients with blood tumor hospital, all patients were treated with CT imaging examination. Analysis of chest X-ray diagnosis and CT diagnosis of pulmonary invasive fungal infection rate, type of lung fungal infection, pathogenic bacteria distribution proportion, CT image characteristics of patients with manifestations. Results 35 patients had pulmonary invasive fungal infection, the infection rate was 51.47%; the patients by CT imaging detection of pulmonary fungal infection, type of pulmonary fungal infection are diffuse, aspergilloma, consolidation and nodule type accounted for 37.14%, 25.71%, 22.86% and 14.29%; 35 patients were in accordance with the "national pathogenic clinical examination procedures > diagnosis, there were positive, the positive rate was 100%; 8 cases of chest X-ray film diagnosis was positive And the positive rate was 22.85%; CT imaging diagnosis of 31 cases, the positive rate was 88.57%, the positive rate of CT was significantly higher than that of imaging diagnosis of chest X-ray diagnosis, there was significant difference between two groups (P0.05); the distribution of pathogenic bacteria is mainly by Aspergillus species, followed by Candida, Cryptococcus yeast bacteria; characteristics including nodules or masses CT imaging halo sign, cavity. Conclusion CT imaging diagnosis of invasive fungal infection in the lungs is very important, can provide diagnostic evidence, especially in the early treatment of pulmonary fungal infection in patients with underlying diseases, combined with clinical, can be the initial diagnosis of lung fungal infection has good clinical value, is worthy of clinical application.

【作者单位】：绍兴文理学院附属医院放射科;上饶市肿瘤医院放射科;
【基金】：浙江省医药卫生科技基金资助项目(2011KYA135)
【分类号】：R519;R733;R730.44

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