百草枯中毒肺损伤CT征象及临床意义

目的:探讨CT对百草枯中毒肺损伤在治疗过程中影像学特征及在疗效评估中的价值。材料与方法:回顾性分析59例口服百草枯中毒患者影像资料。按病程分为早期(1周以内)、中期(1-2周)及后期(2周);按中毒剂量分为少量组(10~20ml)、中量组(21~30ml)和大量组(30ml),均采取规范的治疗措施后观察百草枯中毒肺损伤治疗过程中肺部CT征象的演变,比较三组病例在不同时期的影像学差异。结果:本组病例治愈45例,死亡14例,2例全部病程中表现阴性,余57例在第1周内肺部CT表现以渗出为主,第1~2周以肺实变及不张为主,2周后主要表现为肺纤维化;少量组主要表现为肺纹理增多和磨玻璃样变,中量组主要表现肺实变,大量组除肺实变及纤维化外,还合并肺外病变。结论:百草枯中毒性肺损伤在治疗过程中CT征象演变有一定的特征性,可有效评估预后。

The CT Symptom and Clinical Value of Lung Injury Resulted From Paraquat Poisoning

Purpose： To explore the image features and to evaluate the CT value curative effect in the treatment of lung injury resulted from paraquat poisoning. Materials and Methods： 59 patients with oral paraquat poisoning were retrospectively analyzed. According to the course,the subjects were divided into early periods（ in 1 week）,middle periods（ 1 to 2weeks） and later periods（ 2 weeks later）; According to the toxic dose,the subjects were divided into small groups（ 10 -20ml）,medial groups（ 21 - 30ml） and large groups（〉 30ml）. We detected the change of lung CT signs after standard treatment for the patients; and then compared the difference of images of the three groups at different periods. Results： 45 cases were cured,while 14 cases were dead. 2 patients were normal in all course of the disease. 57 cases＇ lung CT manifestations were mostly effusion in the first week,then were lung consolidation or pulmonary atelectasis during 1 to 2 weeks; and then pulmonary fibrosis after 2 weeks. The small groups were mainly characterized by increased pulmonary texture and ground glass appearance change,the medial groups were mainly embodied in consolidation of the lung,and the large groups were also with extrapulmonary lesions in addition to the consolidation of the lung and fibrosis. Conclusion： The CT signs of lung injury of patients with paraquat poisoning during intreatment are characteristical,and the CT signs are able to evaluate the prognosis.