肺爆震伤的影像学表现

发布时间：2018-08-28 07:16

【摘要】：目的肺爆震伤病情重,临床救治困难,是爆炸现场死亡的主要原因。本研究探讨肺爆震伤的影像学表现,为临床诊断及治疗提供参考。资料与方法回顾性总结2014年"8.2"昆山爆炸事件引起的37例肺爆震伤患者的烧伤程度、面积、既往病史、辅助急诊治疗等临床资料,分析患者的X线和(或)CT影像表现。结果1 37例患者胸部X线结合(或)CT检查结果显示:肺实质未见明显异常6例(16.2%),肺纹理增粗并斑点状模糊影14例(37.8%),毛玻璃样改变6例(16.2%),肺段或肺叶性实变7例(18.9%),弥漫性实变4例(10.8%)。合并胸腔积液6例(16.2%),气胸、液气胸6例(16.2%),心影增大(并心包积液)4例(10.8%),纵隔血肿2例(5.4%),肋骨骨折9例(24.3%)。X线平片检查阳性率为72.2%(13/18),CT阳性率为92.9%(13/14)。2 5例急诊X线检查肺实质未见明显异常者第2~5天复查出现斑点状、点片状模糊影;9例临床症状加重且有感染征象者CT复查示征象明显加重,原发病灶呈扩大或融合状态。结论影像学检查是诊断肺爆震伤的重要方法,CT检查在病变的检出及病灶范围上优于X线平片,建议此类患者在条件允许时尽早行胸部CT检查。
[Abstract]:Objective Pulmonary detonation is the main cause of death at the scene of explosion. This study investigated the imaging features of lung blast injury and provided reference for clinical diagnosis and treatment. Materials and methods the clinical data of 37 cases of lung blast injury caused by "8.2" Kunshan explosion in 2014 were retrospectively summarized. The clinical data such as burn degree, area, past medical history and emergency treatment were analyzed. The X-ray and / or CT images of the patients were analyzed. Results the results of chest X-ray combined with (or) CT showed that there were no obvious abnormalities in lung parenchyma in 6 cases (16.2%), thickening of lung texture and speckle blur in 14 cases (37.8%), glass-like change in 6 cases (16.2%), and pulmonary segmental or lobar consolidation in 7 cases (18.9%). Diffuse consolidation occurred in 4 cases (10.8%). 6 cases (16.2%) complicated with pleural effusion, pneumothorax, pneumothorax, Pneumothorax was found in 6 cases (16.2%), cardiac shadow enlargement (with pericardial effusion) in 4 cases (10.8%), mediastinal hematoma in 2 cases (5.4%), rib fracture in 9 cases (24.3%). The positive rate of X-ray plain film was 72.2% (13 / 18). The positive rate of CT was 92.9% (13 / 14). CT reexamination showed that the primary lesion was enlarged or fused in 9 patients with aggravation of clinical symptoms and infection. Conclusion Imaging is an important method in the diagnosis of lung blast injury. Ct examination is superior to X-ray plain film in the detection of lesions and the range of lesions. It is suggested that these patients should be examined by chest CT as soon as conditions permit.
【作者单位】：南通大学医学院人体解剖实验室;南通大学第三附属医院;无锡三院影像科;
【分类号】：R816.4

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