急诊CT对胸部外伤后严重程度评价(附128例分析)

目的提高胸外伤CT表现的认识，并分析CT表现与临床严重程度的关系。方法回顾性分析128例胸外伤患者的X线胸片与胸部CT资料，按损伤程度的叶段分布、出血点、血气胸的量分为轻型与重型，并与临床严重程度及预后影像表现比较分析。结果CT轻型表现为肺内磨玻璃样影或合并少量斑片状影，分布于3个叶段以内，共65例，CT重型表现为肺内磨玻璃样影内合并点状、结节状出血高密度影，分布于3个叶段以上至双肺，共53例，均见气胸、积液，另10例为大量胸腔积液肺实变。临床分类轻度58例，重度70例，CT分类与临床分类一致性比较Kappa值为0．825，P〈0．005，出院复查7．6％（5／65）CT轻度胸内病灶未完全吸收，57％（36／63）CT重度胸内病变未完全吸收，两组间差异显著（P〈0．05）。结论胸部外伤后胸部CT表现与临床病情严重程度具有较好的一致性。

Evaluation on the severity of thoracic trauma with emergency CT:an analysis of 128 cases

Objective To elevate the cognition of CT findings of thoracic trauma and to analyze the correlation between CT findings and clinical severity.Methods X-ray chest films and CT data of 128 patients with thoracic trauma were analyzed retrospectively.All the patients whose CT findings were divided into mild type and severe type according to the distribution of injured lobes and segments,hemorrhagic sites and the volume of hemothorax and pneumothorax,and compared with clinical severity and prognostic imaging fin...