多发伤患者CT肺功能成像的临床应用研究

发布时间：2018-03-14 16:15

本文选题：多发伤　切入点：肺挫伤　出处：《昆明医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：探索CT肺功能成像对多发伤患者肺功能评估的价值。方法：收集自2011年1月到2012年12月,创伤后48小时内收住在昆明医科大学第一附属医院的多发伤患者共61例。AIS-ISS评分10-35分,其中多发伤(无肺损伤)患者10例为A组,多发伤(合并肺损伤)患者51例为B组。A组年龄26岁-67岁,平均41.30±12.84岁；B组年龄23岁-70岁,平均41.90±11.54岁。A组体重指数20.2kg/m2-24.4kg/m2,平均22.92±1.55kg/m2; B组体重指数20.2kg/m2-25.4kg/m2,平均22.37±1.71kg/m2。两组间变量均衡性好。所有入选者均在入院当天完成CT肺功能成像检查,即检查CT肺功能成像中的病变累及范围(即累及几个肺段)为“‘N值”和病变部位的CT值变化为“M值”以及肺功能检查(PFT)和血气分析等项检查。结果：1.对入选患者的AIS-ISS分值、体重指数和年龄三项基线资料行均衡性分析,标准化差异分别为0.0538、0.05和0.05,均小于0.1,可认为组间变量均衡性较好。 2.CT肺功能成像与血气分析的数据线性相关性显著(r=0.66,F=44.76,P0.01),CT肺功能成像与PFT的数据线性相关性显著(r=0.68,F=49.88,P0.01),血气分析的数据与PFT的数据线性相关性显著(严0.96F=316.94P0.01) 3.CT肺功能成像“M×N”值与PFT (DLco%)值,比较病例分级结果,差异无统计学意义(x=6.53,P=0.16)；以“M×N”值与血气分析中的(Pa02/Fi02)值,比较病例分级结果,差异无统计学意义(x=5.04P=0.28),以PFT (DLco%)值与血气分析中的(Pa02/FiO2)值,比较病例分级结果,差异有统计学意义(x=83.98P0.05) 结论：1.CT肺功能成像可以评估多发伤患者的肺功能 2.通过CT肺功能成像,可以对多发伤患者肺功能进行分级
[Abstract]:Objective: to explore the value of CT pulmonary function imaging in evaluating pulmonary function in patients with multiple injury. Methods: from January 2011 to December 2012, 61 patients with multiple injuries admitted to the first affiliated Hospital of Kunming Medical University within 48 hours after trauma were enrolled in this study. AIS-ISS scores were 10-35 points, of which 10 patients with multiple injuries (without lung injury) were selected as group A. 51 patients with multiple injuries (complicated with lung injury) were 26 to 67 years old in group B and group A, with an average age of 41.30 卤12.84 years and 23 to 70 years old in group B, respectively. The body mass index (BMI) of group A was 20.2kg / m2-24.4kg / m2 (mean 22.92 卤1.55kg / m2), and that of group B was 20.2kg / m2-25.4 kg / m2 (mean 22.37 卤1.71kg / m2). There was good balance between the two groups. All the participants completed CT pulmonary function imaging on the day of admission. In other words, the range of lesions involved in CT pulmonary function imaging (that is, several lung segments involved) was "N value", the CT value of lesion site was "M value", the pulmonary function examination was PFTs and blood gas analysis and so on. Results 1. The AIS-ISS score, body mass index and age of the selected patients were analyzed. The standardized differences were 0.0538 / 0. 05 and 0. 05 respectively, which were all less than 0. 1. It could be considered that the equilibrium of variables between groups was better. 2. There is a significant linear correlation between CT pulmonary function imaging and blood gas analysis data. There is a significant linear correlation between CT pulmonary function imaging and PFT data. There is a significant linear correlation between CT pulmonary function imaging and PFT data. The correlation between blood gas analysis data and PFT data is significant (strict 0.96 F 316.94 P 0.01). 3. Ct pulmonary function imaging "M 脳 N" value and PFT "DLCO" value were compared. The difference was not statistically significant (P < 0.05). Using "M 脳 N" value and Pa02 / Fi02 value in blood gas analysis, the difference was not statistically significant between the value of "M 脳 N" and the value of PFT DLCoT (0.28%) and the value of Pa02P / FiO2 in blood gas analysis, and the difference was not statistically significant between the value of "M 脳 N" and the value of "DLCoT" (PFT DLCoT) and the value of Pa02P / FiO2 in blood gas analysis. The difference was statistically significant (83.98 P0.05). Conclusion 1. Ct pulmonary function imaging can be used to evaluate pulmonary function in patients with multiple injuries. 2. Lung function can be graded by CT pulmonary function imaging in patients with multiple injuries.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R641

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