本文選題：兒童 + 麻疹　； 參考：《臨床放射學(xué)雜志》2017年10期

【摘要】：目的探討兒童麻疹肺部感染兩種類型的影像學(xué)表現(xiàn),提高和重視對(duì)這一疾病的認(rèn)識(shí)和診斷水平。方法回顧分析82例兒童麻疹肺部感染的影像學(xué)表現(xiàn),結(jié)合臨床資料等,將肺部感染分為麻疹肺炎和麻疹合并肺炎兩種類型,并就兩種感染類型的CRP和PCT等檢驗(yàn)指標(biāo)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果 (1)麻疹肺炎(50例)。X線胸片:肺氣腫31例,肺紋理增多、模糊39例,肺門增大8例,磨玻璃影2例,典型麻疹肺炎22例。CT掃描8例,3例表現(xiàn)為兩下肺散在點(diǎn)片狀模糊影,1例表現(xiàn)為左舌葉小片狀影伴左側(cè)胸膜增厚,1例為右上肺及左下肺的小片狀影,其余3例CT檢查正常。(2)麻疹合并肺炎(32例)。X線胸片:兩肺紋理增多、模糊20例,肺門增大4例,小葉性麻疹合并肺炎9例,多肺段或大葉性肺實(shí)變23例,磨玻璃影4例,氣胸及縱隔皮下氣腫3例。CT掃描7例,包括兩肺多發(fā)片絮狀影3例,兩肺大片狀實(shí)變影4例,伴發(fā)磨玻璃影4例,氣胸及縱隔皮下氣腫3例,其中1例合并心包積氣。(3)采用Mann-Whitney U檢驗(yàn),結(jié)果顯示,CRP在麻疹肺炎與麻疹合并肺炎、典型麻疹肺炎與小葉性麻疹合并肺炎之間指標(biāo)Z差異無統(tǒng)計(jì)學(xué)意義。PCT在麻疹肺炎與麻疹合并肺炎、典型麻疹肺炎與小葉性麻疹合并肺炎之間指標(biāo)Z差異有統(tǒng)計(jì)學(xué)意義(P0.001)。結(jié)論兒童麻疹肺部感染兩種類型的影像學(xué)表現(xiàn)具有一定的特征,結(jié)合CRP及PCT等檢驗(yàn)指標(biāo)分析,有助于提高對(duì)兩者的認(rèn)識(shí)和鑒別水平。對(duì)于提高診斷水平和指導(dǎo)臨床治療及療效評(píng)估有重要意義。
[Abstract]:Objective to investigate the imaging manifestations of two types of measles pulmonary infection in children, and to improve the recognition and diagnosis of the disease. Methods the imaging findings of 82 children with measles pulmonary infection were retrospectively analyzed. Combined with clinical data, pulmonary infection was divided into two types: measles pneumonia and measles combined with pneumonia. The CRP and PCT of two types of infection were analyzed statistically. Results (1) chest radiographs of 50 cases of measles pneumonia: 31 cases of emphysema, 39 cases of pulmonary texture, 39 cases of blur, 8 cases of enlargement of hilum, 2 cases of vitreous opacity. 22 cases of typical measles pneumonia. Ct scan in 8 cases, 3 cases showed two inferior lung scattered in the spot flaky blur shadow. 1 case showed left lobular flake shadow with left pleural thickening. 1 case showed small flake shadow of right upper lung and left lower lung, and 1 case showed small slice shadow of right upper lung and left lower lung. The rest 3 cases had normal CT examination. (2) chest radiographs of measles complicated with pneumonia (32 cases). X ray chest film showed that there were 20 cases of enlargement of both lungs, 4 cases of enlargement of hilum, 9 cases of lobular measles complicated with pneumonia, 23 cases of multisegmental or lobar pulmonary consolidation, 4 cases of glass opacity. 3 cases of pneumothorax and mediastinal subcutaneous emphysema. Ct scan included 3 cases of flocculent film of two lungs, 4 cases of large flake solid shadow of two lungs, 4 cases of vitreous opacification, 3 cases of pneumothorax and mediastinal subcutaneous emphysema, 3 cases of pneumothorax and mediastinal subcutaneous emphysema. (3) Mann-Whitney U test was performed in 1 case with pericardial accumulation of qi. The results showed that CRP was detected in measles pneumonia and measles complicated pneumonia. There was no significant difference in Z between SARS and lobular measles complicated pneumonia. PCT was statistically significant between measles pneumonia and measles complicated pneumonia, and between typical measles pneumonia and lobular measles complicated pneumonia (P0.001). Conclusion the imaging findings of two types of children with measles pulmonary infection have certain characteristics. The analysis of CRP and PCT is helpful to improve the recognition and differential level of the two types. It is of great significance to improve the diagnostic level and guide the clinical treatment and evaluation of curative effect.
【作者單位】： 東南大學(xué)附屬第二醫(yī)院放射科;
【分類號(hào)】：R725.1;R816.92

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