煤工尘肺合并肺癌临床分析

煤工尘肺是一种煤矿工人容易罹患的常见职业病,其危害大,严重影响患者的生活质量,难以彻底根治,而且容易合并其他肺部疾患。其中,当煤工尘肺合并肺癌的情况下,因其临床症状不典型,易被忽视而延误治疗或导致误诊。尽管煤工尘肺合并肺癌的发生率一般较低,但必须予以重视,力争做到及时发现、及早诊断、及早治疗,避免因延误治疗而造成严重后果。     

煤工尘肺肺气肿并发双侧气胸8例分析

媒工尘肺气胸是尘肺晚期常见的并发症之一，一般多发生在尘肺伴有严重肺气肿和肺大泡的患者。尘肺气胸多见为单侧，有时可见双侧，双侧气胸的症状严重并发呼吸衰竭频率极高。本科1991～2000年共收治双侧气胸8例，报道如下。     

80例支气管肺癌CT扫描与X线胸片对比分析

本文分析80例支气管肺癌患者的CT所见,并与X线胸片进行对比,结果80例在CT上均有阳性所见,CT比胸片异常表现增多者20例,与胸片所见相似者60例,其中5例在胸片上阴性。通过对比可见,CT对发现微小和隐蔽部位病灶的能力,对显示肿瘤与周围结构之间关系的能力,判断侵犯纵隔和胸膜情况的能力,判断术后肿瘤有无复发,或经放疗、化疗后观察残留病灶情况,确定下一步治疗方案有很大帮助。最后对CT的作用作一讨论。     

煤工尘肺合并肺结核的临床分析

煤工尘肺合并肺结核是尘肺较严重的并发症之一,也是造成死亡的主要原因,因为粉尘与结核病的协同作用,使临床症状与X线胸片表现上改变了各自独有的特征,易造成漏诊和误诊,从而延误治疗。及早识别与正确诊断尘肺结核,可使病人得到及时的抗痨治疗,降低死亡率,我院自1995～2005年共收治煤工尘肺合并肺结核患者226例现分析如下。1临床资料1.1一般资料我院近10年共收治煤工尘肺患者860例。其中尘肺肺结核226例,占26.3%,226例均为男性,年龄50～94岁,平均72.5岁,Ⅰ期尘肺128例,Ⅱ期尘肺68例,Ⅲ期尘肺38例。1.2临床表现尘肺肺结核患者症状有咳嗽、胸…     

煤工尘肺肺部真菌感染102例临床分析

肺部真菌感染是病死率较高的疾病,煤工尘肺有肺部基础疾病,极易发生肺部真菌感染。本病无特殊临床症状及体征,也无特异的X线表现,所以极易造成临床医生的忽视。现对本院2005年元月至2006年元月因患煤工尘肺在我院住院期间发生肺部真菌感染102例患进行分析。[第一段]     

淮北矿区78例煤工尘肺支气管镜检查及分析

目的探讨纤维支气管镜检查在煤工尘肺及其并发症诊断中的应用价值。方法对78例煤工尘肺经纤维支气管镜观察、活检、刷检。结果所有煤工尘肺受检查者在纤支镜下均存在粘膜表面斑片状发黑区及不同程度的支气管狭窄、变形等改变,同时尘肺融合灶可能并存结核或者恶性肿瘤。结论支气管镜检查对我国尘肺的诊断工作起到很大的促进作用。     

煤工尘肺合并肺结核60例临床分析

煤工尘肺患容易合并肺结核，其合并率随尘肺期别的晋级而增高。两病并发，相互影响，致使病情复杂，更容易出现其它并发症。现将我院结核病区2001年10月～2004年9月收治的60例煤工尘肺合并肺结核患进行临床分析如下：     

煤工尘肺合并脑梗死34例临床分析

目的探讨煤工尘肺合并脑梗死的发生率及危险因素。方法收集我院130例煤工尘肺住院患者的临床资料并进行分析。结果发现并发脑梗死的患者有34例,患病率为26.15%。结论对煤工尘肺患者应积极治疗原发病,控制血糖、血脂、血压等危险因素,是预防脑梗死的关键。     

煤工尘肺继发肺部真菌感染临床分析

目的 探讨煤工尘肺继发肺部感染的常见易患因素和对策.方法调查90例煤工尘肺继发肺部真菌感染.结果 感染发生率14.16%,主要病原菌为白色念珠菌(49.61%);年龄>60岁、严重基础疾病、抗生素滥用、激素、化疗、侵入性操作及低蛋白血症等为感染的危险因素.结论 长期使用广谱抗生素和糖皮质激素是煤工尘肺患者继发肺部真菌感染的主要高危因素.     

煤工尘肺者动态心电图心律失常分析

采煤工人肺内吸人大量粉尘,易发尘肺病。主要并发症肺部感染、肺气肿、肺心病甚至猝死等。严重影响心肺功能。又因上述等因素并发心律失常。为了探讨尘肺患者并发心律失常的规律和有效治疗。现将100例尘肺患者24h动态心电图(DCG)分析结果报告如下。     

Differential diagnosis of pulmonary nodular mucinous adenocarcinoma and tuberculoma with dynamic CT: a retrospective study

BackgroundPulmonary nodular mucinous adenocarcinoma (PNMA) tends to be easily misdiagnosed as tuberculoma in practice. In this study, we aimed to discriminate PNMA from tuberculoma with dynamic computed tomography (CT).MethodsIn this study, 38 consecutive pathologically confirmed cases of PNMA and 23 cases of tuberculoma from January 2015 to December 2019 were retrospectively collected. The mean CT attenuations of each lesion were examined. The values on the plain scan, the venous scan, and the enhanced values (CT attenuation of lesion of venous scan minus that of the plain scan) were tested with an independent t-test pair-wisely. Receiver operating characteristic (ROC) curve analyses were performed to test the differential diagnosis values. The presence of satellite lesions was determined with the chi-square test.ResultsThe mean CT attenuation of tuberculoma shown on the plain scan was significantly higher than that of PNMA (35.15±16.00 vs. 24.00±12.67 HU; P<0.01). The enhanced value of tuberculoma on venous scan was significantly lower than that of PNMA (13.44±13.40 vs. 22.52±14.00 HU; P=0.02). The optimum CT attenuation of the plain scan and the enhanced value for differential diagnosis were 28.80 and 14.25 HU [area under the curve (AUC) =0.72, 95% confidence interval (CI): 0.58–0.86; and AUC =0.70, 95% CI: 0.59–0.84], with sensitivity (78.3% vs. 71.1%) and specificity (63.8% vs. 69.6%) respectively. The satellite lesions were more often observed in the tuberculoma group (P<0.01).ConclusionsThe CT attenuation of the plain scan, the enhanced value after enhancement, and the presence of satellite lesions might be useful in differentiating PNMA from tuberculoma.     

Intrapulmonary recurrence after computed tomography-guided percutaneous needle biopsy of stage I lung cancer

Tumor seeding, along the needle tract after percutaneous needle biopsy, is a rare condition and most of the reported cases are implantation metastasis, which occurred in the chest wall or the pleura. We present a case of implantation metastasis that occurred in the pulmonary parenchyma, after a computed tomography-guided percutaneous needle biopsy (CT-PNB) of stage I lung cancer.     

X线平片与多层螺旋CT诊断周围型肺癌的对照研究

目的比较X线平片及螺旋CT对周围型肺癌影像学征象的显示情况。方法选择周围型肺癌患者40例,所有患者均接受X线平片及螺旋CT检查,观察周围型肺癌的X线平片及螺旋CT图像特征。比较两种检查方法对周围型肺癌征象的显示情况。结果 1.共40处病灶,左肺22例,右肺18例,均为单发。直接征象包括肿块、磨玻璃征、空洞。间接征象包括胸膜凹陷、毛刺征、分叶征、血管集束征、棘状突起、支气管气象征、空泡征及胸腔积液。2.螺旋CT对周围型肺癌空洞、毛刺征、空泡征、血管集束征及胸膜凹陷征的显示率显著高于X线平片,其差异均具有统计学意义(P<0.05)。结论螺旋CT具有高时间分辨率、空间分辨率及密度分辨率,对周围型肺癌各种征象的显示中显著优于X线平片。     

Assessment of intrathoracic lymph nodes by FDG PET/CT in patients with asbestos-related lung cancer

BackgroundThis study explored the assessment of intrathoracic lymph node metastasis by 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography computed tomography (PET/CT) in patients with asbestos-related lung cancer (ARLC).MethodsWe retrospectively reviewed the data on 35 patients with ARLC who underwent preoperative FDG-PET/CT and surgical resection between January 2012 and December 2018. We collected medical information from medical records and imaging systems and examined the FDG uptake in each lymph nodal region resected by surgery and the presence or absence of pathological lymph node metastasis.ResultsPathological lymph node metastases were detected in 14 (8.70%) of 161 nodal stations. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG-PET/CT were 71.4% (10/14), 87.8% (129/147), 35.7% (10/28), 97.0% (129/133), and 86.3% (139/161), respectively. Six of the eight false-positive patients had bilateral accumulations, whereas all six true-positive patients had unilateral accumulation (P=0.006). On histopathological examination, the false-positive nodes showed disruption of lymphoid follicles in the cortex, infiltration of histiocyte-like cells in the medulla, fibrous micronodules, and severe anthracosis.ConclusionsPET/CT scans of patients with ARLC showed comparable sensitivity and specificity to those of PET/CT scans of patients with conventional lung cancer reported in the literature. Many false-positive cases also showed bilateral symmetric accumulation. This method can be used to evaluate lymph node involvement in lung cancer.     

急性胰腺炎CT检查时机选择

目的探讨急性胰腺炎患者最佳CT检查时间。方法本研究选择2008年1月~2010年3月对确诊的172例急性胰腺炎的患者,随机分为3组,分别在发病≤12 h、12~24 h、48~72 h行CT检查。为观察病情变化,在发病≤12 h行CT检查的患者在72~120 h期间行第二次CT检查,分析不同时间段的CT检出率和Balthazar分级情况,以确定最佳CT检查时间。结果随着时间的推移,CT检查发现胰腺炎的阳性率逐渐增高,88.7%的患者12~24 h CT检查阳性率明显高于在发病12 h之内行CT检查的阳性率,差异显著（P〈0.05）,但与在发病48~72 h和72~120 h行CT相比,无显著差异（P〉0.05）。按照Balthazar CT分级标准,对确诊的胰腺炎患者不同时间段分级进行研究发现：随着时间的延长,患者D级、E级检出率逐渐增多,48~72 h D级、E级检出率明显高于12 h之内和12~24 h之间检出率（P〈0.05）;但与72~120 h相比,无显著性差异（P〉0.05）。结论对于疑诊胰腺炎的患者在发病12~24 h行CT检查可较早检测到胰腺炎的变化;在48~72 h行CT检查可较早检测到胰腺炎的严重程度。     

细支气管肺泡癌的临床、胸片和CT诊断分析

目的 回顾分析30例细支气管肺泡癌的诊断。方法 对30例经病理证实的肺泡癌进行X线和CT检查,探讨各种诊断方法的价值。结果 临床、胸片和CT的确诊率分别为20％、50％和73．3％。CT在显示病灶内部结构、边缘和纵隔淋巴结转移等方面明显优于胸片。结论 综合运用各种技术对提高肺泡癌的诊断水平是十分重要的。     

痛风性关节炎的 X 线平片、CT 和 MR 的对比研究

目的：对比研究痛风性关节炎的 X 线平片、CT 和 MRI 表现,并探讨临床资料与影像学表现的关系。方法选择33例患者的54个确诊为痛风性关节炎的关节为研究对象,上午空腹查血尿酸,下午记录临床资料,并做平片、CT 和 MRI 检查。影像表现的评价指标包括痛风石、骨质破坏、软组织肿胀、关节积液、滑膜增厚和骨髓水肿。统计分析方法包括卡方检验、独立样本 t 检验和逻辑回归分析。结果卡方检验分析不同检查方法下痛风石阳性的关节数(CT>平片、MR>平片, P<0.01),软组织肿胀(MR>CT>平片,P<0.01),关节积液(MR>CT, P<0.01)。此外,MRI 发现骨髓水肿35例,滑膜增厚50例。独立样本 t检验显示有痛风石的患者病程长于无痛风石的患者(P<0.01)。 Logstic 回归分析痛风石的致病因素,骨质破坏和病程入选(P<0.01)。结论对于痛风的早期诊断,MRI 优于 CT 和平片。痛风石和骨质破坏可能不会影响血尿酸水平。随着病程的延长,痛风石形成的几率也升高。痛风石的形成与骨质破坏可能是相互促进的关系。