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甲型H1N1流感重症和危重症患者胸部HRCT表现及动态变化

张昊凌 施裕新 张志勇

中国临床医学2017,Vol.24Issue(1):21-25,5.
中国临床医学2017,Vol.24Issue(1):21-25,5.DOI:10.12025/j.issn.1008-6358.2017.20160798

甲型H1N1流感重症和危重症患者胸部HRCT表现及动态变化

Characteristics of chest HRCT and dynamic changes in severe and critical patients with novel H1N1 influenza A

张昊凌 1施裕新 2张志勇1

作者信息

  • 1. 复旦大学附属中山医院放射科,上海 200032
  • 2. 上海市公共卫生临床中心影像科,上海 201508
  • 折叠

摘要

Abstract

Objective:To evaluate chest HRCT (high-resolution computed tomography )characteristics and dynamic changes in patients with novel H1N1 influenza A infection,and briefly analyzes the relationship between the imaging characteristics and clinical prognosis.Methods:Clinical data and imaging findings of 66 cases with confirmed severe and critical H1N1 were analyzed retrospectively.All of the cases received chest HRCT scans in admission to hospital and discharge, scanning interval 2-16 d,average follow-up (2.67±1.05)times.Results:Among the 66 patients,50 cases of male and 16 cases of female,with an average age of (40.42±15.54)years old.The characteristics of chest HRCT findings and dynamic changes were as follows:patchy exudation focus of lung parenchyma was the main finding,while ground glass opacities in 3 cases.The moderate manifestation was pure consolidation focal distribution,or scattered pieces of consolidation and ground glass opacity in 24 cases,which located in the sub-pleural regions.The severe 35 cases manifestated with a large patch of consolidation and there was air bronchogram in the consolidation.Examination in over 3 days showed the progress in pathological changes.Over 7 days after infection,all of lung appear multiple spot piece of shadow;consolidation and ground glass opacity in 19 cases.A large area of consolidation mainly in 10 cases,16 cases of pleural effusion.Three days after admission,the lesions of 6 cases were obvious deterioration,15 cases were significantly reduced,the lesions of lung can be appeared fibrosis between 41 cases.It was common that with pleural reaction,but lymph node involvement was infrequent. Conclusions:There are some radiographic characteristics in novel H1N1 influenza A infection.Severe and critical patients is easily attacked by pulmonary infection,chest disease progression,some people can lead to respiratory failure.Chest imaging examination can play an important role in the early diagnosis.Getting familiar with chest HRCT appearances and dynamic changes is helpful for its early diagnosis and the abnormal changes after medical treatment.

关键词

甲型H1N1流感/高分辨率计算机体层X线摄影术/胸部

Key words

novel H1N1 influenza A infection/high-resolution computed tomography/chest

分类

医药卫生

引用本文复制引用

张昊凌,施裕新,张志勇..甲型H1N1流感重症和危重症患者胸部HRCT表现及动态变化[J].中国临床医学,2017,24(1):21-25,5.

中国临床医学

OACSTPCD

1008-6358

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