56例重症SARS病例的影像学表现

目的 :探讨重症严重急性呼吸综合征 (SARS)的胸部影像学表现。方法 :对我院 2 0 0 3年 4月 5日～ 5月 3 1日收治的 5 6例重症SARS患者的临床、实验室、影像学资料进行回顾性分析。结果 :5 6例重症SARS中 :①发热比例高( 5 3 /5 6,95 % ) ,且大多数为高热 ;②发病早期绝大多数患者实验室检查血白细胞下降 ( 3 6/5 6,64 % ) ;③胸片和CT检查提示肺部炎症出现早、病变累及范围大 ,6例病变范围在 80 %～ 90 % ,90 %以上 5例 ;④急性肺损伤 (ALI)和急性呼吸窘迫综合征 (ARDS)的发生率高 ( 13 /5 6,2 1% )。 12例死亡病例中 7例为ARDS合并多器官功能衰竭 (MODS)。结论 :认识重症SARS影像学表现 ,将ALI和ARDS作为重症非典型肺炎的诊断标准 ,采取综合支持治疗措施对降低重症患者病死率有重要意义。

Analysis of the imaging features of SARS in 56 severe cases

Objective:To study the chest imaging appearances of severe acute respiratory syndrome (SARS). Methods: From April 5, 2003 to May 31, 2003,137 patients with SARS were admitted to the isolated ward of our hospital,56 cases of them were severe. Their clinical and laboratory data,and chest imaging were analyzed.Results:There was high percentage of high fever (53/56, 95%) with low WBC count (36/56, 64%). Early sign of SARS on chest radiograph and CT scans was inflammatory lesion with large extent involved. The involved area was around 80% to 90% of lung field in 6 cases, and greater than 90 percent in 5 cases.The incidence of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) was very high (21%,13/56).7 of 12 dead cases were due to concurrent multiorgans dysfunction (MODS). Conclusion: Cognition of imaging features of SARS,especially the signs of ALI and MODS as the diagnosis of serious SARS,is very important for the diagnosis of the disease and its treatment planning.