本文選題：多層螺旋CT + 侵襲性肺曲霉菌��； 參考：《中華醫(yī)院感染學雜志》2017年09期

【摘要】：目的觀察和分析多層螺旋CT(MSCT)在侵襲性肺曲霉菌感染病情和預后預測中的價值,為制定合理臨床診療方案提供客觀依據。方法選取2014年3月-2016年7月的疑似侵襲性肺曲霉菌感染患者80例為研究對象,確診為侵襲性肺曲霉菌感染59例,以病理學及痰培養(yǎng)為診斷金標準,對MSCT在侵襲性肺曲霉菌感染診斷中的價值進行評價;對確診為侵襲性肺曲霉菌感染患者的病灶部位分布進行觀察和分析;對合并侵襲性肺曲霉菌感染的血液病與非血液病患者的MSCT征象進行觀察和比較;對所有確診患者進行為期6周的隨訪,將臨床癥狀明顯改善患者列為預后良好組,將臨床癥狀惡化或死亡的患者列為預后不良組,對兩組患者治療前及治療6周時的MSCT表現(xiàn)進行分析和比較。結果 MSCT診斷侵襲性肺曲霉菌感染的靈敏度為93.2%、特異度為76.2%、陽性預測值為91.7%、陰性預測值為80.0%;侵襲性肺曲霉菌感染患者MSCT下病灶部位多為雙肺多發(fā),占42.4%,在肺葉分布中,以上葉分布為主,占55.9%,外周帶分布較多,占69.5%;合并侵襲性肺曲霉菌感染的血液病患者的實變影和團塊影的分布率顯著高于非血液病患者,差異有統(tǒng)計學意義(P0.05);在治療6周時,預后不良組患者各類MSCT征象的出現(xiàn)率均高于預后良好組,差異均有統(tǒng)計學意義(P0.05)。結論 MSCT在侵襲性肺曲霉菌感染輔助診斷中具有一定價值,患者的CT征象與其基礎疾病、預后情況具有一定的相關性,可作為評價病情和預測預后的輔助手段。
[Abstract]:Objective to observe and analyze the value of MSCT in predicting the condition and prognosis of invasive pulmonary aspergillosis, and to provide an objective basis for rational clinical diagnosis and treatment. Methods from March 2014 to July 2016, 80 patients with suspected invasive pulmonary aspergillus infection were selected as study subjects, 59 patients were diagnosed as invasive pulmonary aspergillus infection, pathology and sputum culture were used as diagnostic gold criteria. To evaluate the value of MSCT in the diagnosis of invasive pulmonary aspergillus infection, to observe and analyze the location distribution of the lesions in the patients with invasive pulmonary aspergillus infection. The MSCT signs of patients with invasive pulmonary aspergillosis were observed and compared with those of non-hematological patients, and all the patients were followed up for 6 weeks, and the patients with improved clinical symptoms were classified as the group with good prognosis. The MSCT findings of the two groups before treatment and 6 weeks after treatment were analyzed and compared. Results the sensitivity, specificity, positive predictive value and negative predictive value of MSCT in the diagnosis of invasive pulmonary Aspergillus pneumoniae infection were 93.22.The positive predictive value was 91.7and the negative predictive value was 80.0.The lesions under MSCT of invasive pulmonary aspergillus infection patients had multiple lesions in both lungs (42.4%). The distribution of the above lobes was dominant (55.9%), and the distribution of peripheral zones was more (69.5%). The distribution rates of solid and mass shadows in patients with invasive pulmonary aspergillosis were significantly higher than those in non-hematological patients (P 0.05), and at 6 weeks after treatment, the distribution rates of solid and mass shadows were significantly higher in patients with invasive pulmonary aspergillosis than in patients with non-hematological diseases (P 0.05). The incidence of various MSCT signs in patients with poor prognosis was higher than that in patients with good prognosis (P 0.05). Conclusion MSCT has a certain value in the auxiliary diagnosis of invasive pulmonary aspergillus infection. The CT findings of the patients have a certain correlation with their underlying diseases and prognosis, which can be used as an auxiliary means to evaluate the condition of the disease and predict the prognosis.
【作者單位】： 武警吉林總隊醫(yī)院放射線科;
【基金】：吉林省衛(wèi)生廳科研基金資助項目(2014ZC007)
【分類號】：R519;R816.41

【相似文獻】

相關期刊論文 前9條

1 余兵;高占成;張榮葆;周云杉;;侵襲性肺曲霉菌感染1例報告并文獻復習[J];中國臨床醫(yī)生;2013年09期

2 王利玲;楊勇剛;吳強鵬;;侵襲性肺曲霉菌19例臨床分析[J];吉林醫(yī)學;2011年16期

3 譚森;陳家璇;;侵襲性肺曲霉菌感染1例[J];臨床合理用藥雜志;2011年04期

4 王蔚;周愚;趙靈;蘇真嬌;張艷軍;;侵襲性肺曲霉菌感染診治進展[J];中國呼吸與危重監(jiān)護雜志;2011年05期

5 栗方;王龍;曹彬;張雨雨;劉穎梅;;侵襲性肺曲霉菌體外藥敏試驗與分子鑒定及基因分型研究[J];中華醫(yī)院感染學雜志;2014年06期

6 黎庶;張立娜;王欣;劉婷;李佩玲;謝秀麗;徐克;;侵襲性肺曲霉菌感染CT征象的早期表現(xiàn)及其隨訪觀察[J];中國臨床醫(yī)學影像雜志;2009年08期

7 陳玉玲;左麗娜;張文輝;卞宏;徐凱;;侵襲性肺曲霉菌感染CT特征與預后[J];臨床放射學雜志;2013年02期

8 陳剛;曹治婷;鄒瑩;劉正剛;;白血病并發(fā)侵襲性肺曲霉菌感染的放射學診斷[J];放射學實踐;2010年02期

9 ;[J];;年期

相關會議論文 前3條

1 余兵;高占成;周云杉;;侵襲性肺曲霉菌感染1例報告及文獻復習[A];中華醫(yī)學會呼吸病學年會——2011（第十二次全國呼吸病學學術會議）論文匯編[C];2011年

2 余兵;高占成;周云杉;;侵襲性肺曲霉菌感染1例報告及文獻復習[A];中華醫(yī)學會第七屆全國呼吸道感染學術大會暨第一屆多學科抗感染治療學術研討會論文匯編[C];2011年

3 姜艷霞;穆曉東;王昆;康健;李爾然;;血清半乳甘露聚糖試驗對侵襲性肺曲霉菌感染的診斷價值[A];中華醫(yī)學會呼吸病學年會——2013第十四次全國呼吸病學學術會議論文匯編[C];2013年

相關重要報紙文章 前1條

1 南京軍區(qū)南京總醫(yī)院呼吸內科教授 李培　本報記者 曾令浩 整理;溺水后,警惕侵襲性肺曲霉菌感染[N];醫(yī)藥經濟報;2011年

，

本文編號：1907768