百草枯急性中毒致肺损伤的X线和CT表现分析

Analysis of X-ray and CT Imaging Findings of Lung Injury in Acute Baicaoku Poisoning

目的探讨X线、CT在百草枯急性中毒致肺损伤中的影像学征像和诊断价值。方法回顾性分析24例误服百草枯急性中毒致肺损伤X线、CT影像学资料。结果24例百草枯急性中毒死亡6例,肺纤维化15例,痊愈出院3例。24例患者按中毒时间分中毒早期(5天以内)X线胸部均未见异常改变,18例HRCT检查显示肺呈轻微磨玻璃改变;中毒中期(5-14天)X线显示两肺中下野线状、条状密度增高影,其中3例显示两肺血管模糊、肺门阴影显示不清,心影稍有增大。HRCT显示肺间质纤维化、肺气肿、双肺广泛磨玻璃影。中毒后期(14天以后)X线、CT显示以肺实变和渗出为主表现,提示预后差。结论X线、CT检查对百草枯急性中毒肺损伤的发现和进展分析具有明显优势,特别是HRCT对早期肺损伤的轻微病变及肺水肿改变具有一定的特征性,是指导临床治疗用药的重要依据。

Objective: To investigate the X-ray and CT features of lung injury in acute Baicaoku poisoning. Methods:24 cases X-ray and CT image of lung injury in acute Baicaoku poisoning were analyzed retrospectively. Results: In these 24 cases of lung injury in acute Baicaoku poisoning,6 cases patients died ,in 15 cases pulmonary fibrosis is noted, in 3 cases patients recovered and to be discharged. According to periods of poisoning, the 24 cases were divided into 3 types: The early stage of poisoning (within 5 days), plain chests in alls were nothing remarkable, 18 cases showed slight ground glass changes in HRCT examinations. The middle stage of poisoning(5-14 days), plain chests showed dark linear, tripes in both middle and inferior fields, including 3 cases showed hazy in both fields, the lung showed unclear, the heart became more enlargement, and showed pulmonary interstitial fibrosis, emphysema and more dark hazy were showed in both lung fields. The late stage of poisoning: X-ray and CT found more consolidation and exudation, that showed terrible prognosis. Conclusion: The X-ray and CT examination have more predominance for the lung injury in acute Baicaoku poisoning in analysis of its found and evolved, especially the HRCT has characteristic in that could show the slight changes and pulmonary edema in early lung injury, and it is also the important gist for clinical treat.