| 摘 要: 目的 回顾性分析口服百草枯中毒存活患者的临床资料及肺HRCT和肺功能的变化等指标，探讨百草枯中毒患者不同时期肺部损伤情况及临床意义。方法 从2013年1月至2014年1月我科收治的急性口服百草枯中毒存活患者中，选取符合标准的病例37例,将患者分为轻度中毒组和重度中毒组，重点分析各组于中毒后第1天、3天、7天、14天、2l天、8周、20周肺部HRCT影像学检查，中毒后3周、8周、20周肺功能及相应体力负荷耐受情况。结果 急性百草枯中毒患者的肺HRCT影像学表现主要为渗出、纤维化、胸腔积液、气胸、胸膜肥厚、肺间质病变等，部分病例伴有心包膜肥厚、心包积液；轻度中毒患者发病至远期恢复，肺HRCT影像学均无明显变化；重度中毒患者，渗出性病变、胸膜肥厚、纤维样变的远期与早期、中期、后期比较均P<0.05；胸腔积液远期与早期、中期比较P<0.05；间质病变中期与早期、后期、远期比较P<0.05,早期与后期比较P>0.05。轻度中毒组与重度中毒组肺功能异常率比较P<0.05；重度组患者FEV1.0/FVC%、TLCOSB、VC、TLC、FVC、FEV1.0等指标与轻度患者比较，均P<0.05。结论 重度百草枯中毒存活患者肺HRCT呈现动态变化；肺功能障碍以通气障碍为主，少数患者存在肺弥散功能障碍。肺功能的异常随着时间的延长、肺HRCT的好转而好转。 |
| 关键词: 百草枯中毒 肺损伤 肺HRCT 肺功能 随访 |
|
中图分类号: R595.4
文献标识码:
|
| 基金项目: |
|
| Dynamic changes of pulmonary HRCT imaging and lung function of survival paraquat poisoned patients |
|
Song Chengzhen,Jian Xiangdong
|
|
Department of Posioning and Occupational Diseases, Qilu Hospital of Shandong University,Jinan 250012,China
|
| Abstract: Objective To explore the detail situation in pulmonry injury at different periods of paraquat poisoning and their clinical significance by retrospective analysis on clinical information and dynamic changes of pulmonary HRCT imaging and lung function. Methods 37 patients of paraquat poisoning admitted in Shandong University Qilu Hospital from January 2013 to January 2014 were enrolled as study objects, clinical information including laboratory tests results during adimissionwere collected. The patients were divided into mild and severve groups, their pulmonary HRCT imagings at 1，3，7，14，2l days, 8 weeks and 20 weeks after hospitalization and pulmonary function even corresponding physical load tolerance situation at 1, 21 days, 8 weeks，and 20 weeks were. all analyzed. Results The results showed that the main characteristic of pulmonary HRCT imagings in paraquat poisoned patients were exudation , fibrosis, pleural effusion, pneumothorax, pleural thickening, interstitial lung damage, ect. There is no obvious change in HRCT imaging manifestations in mild group, but there were some significant difference in the imaging changes mentioned above with the periods of illness. he abnormal rate of pulmonary fuction had significant difference (P<0.05) between mild and severe groups and the values of FEV1.0 / FVC %, TLCOSB, VC, TLC, FVC, FEV1.0 between mild and severe groups were also significantly different (P<0.05). Conclusion Severe paraquat poisoning patients had dynamic changes in lung HRCT; the lung manifested mainly as ventilation dysfunction, a few patients also showed pulmonary diffuse dysfunction, and pulminary function might get better with time and improvement of pulmonry HRCT imagings. |
| Keywords: paraquat poisoning lung injury lung HRCT lung function followed-up visit |
