高原肺水肿的早期影像检查及影像表现探讨

目的对高原肺水肿（high altitude pulmonary edema,HAPE）的早期影像学表现进行探讨,为HAPE的早期诊断寻找更为可靠的检查手段和依据。方法对482例经临床筛选出的高度疑似HAPE对象进行常规X线检查及CT扫描;对确诊为HAPE的病例,在治疗恢复过程中的肺部病变进行动态观察,分析HAPE病例的X线检查及CT扫描特点。结果 482例高度疑似HAPE对象中,确诊为HAPE142例。常规X线检查,142例HAPE患者中,47例（33.10%）发现肺部有明确改变,95例（66.90%）未发现明确改变;CT扫描,142例HAPE患者均存在水肿,且以肺间质异常为主。其中磨玻璃样改变61例（42.96%）,小结节样影34例（23.94%）,散在、孤立终末支气管肺泡水肿15例（10.56%）,纤细网纹状影13例（9.15%）,肺纹理增粗、增多12例（8.45%）,大片状云絮样影7例（4.93%）。142例HAPE早期患者治疗过程中,CT扫描均能清楚地反应肺部病变的恢复情况,其中1例第11d再次复查病变仍呈少量磨玻璃样改变残留。结论 HAPE早期肺部病变以肺间质异常为主,此时常规X线检查容易漏诊,对于临床症状明显,而常规X线检查肺部未见明显异常的高度疑似HAPE病例,CT扫描具有重要诊断价值。

Investigation of image examination and pulmonary image of high altitude pulmonary edema in early stage

Objective To explore the pulmonary image of high altitude pulmonary edema(HAPE)in early stage,and to find a more reliable method of the early diagnosis of HAPE.Methods 482 people suspected highly as HAPE through clinical screening received routine X-ray examination and CT scanning.Then the pulmonary lesions of those diagnosed finally as HAPE were observed during restoration process after treatment,and their X-ray and CT characteristics were analyzed.Results Among above 482 subjects,142 cases were diagnosed ...