严重肺挫伤胸部CT影像与临床病程分期

Severe pulmonary contusion CT image and clinical process classification

目的结合临床和系列胸部CT确定肺挫伤病程的临床病理生理分期。方法分析351例胸外伤患者的临床资料、病情转归和1228次系列胸部CT图像的变化规律，将肺挫伤的病程分期。结果创伤性肺挫伤可以按病程和创伤后病理生理变化分为急性创伤期，肺渗出期，胸腔渗出期，吸收好转期，各期都具有较明显的临床及胸部CT影像学的特点。急性创伤期同时根据受伤的严重程度还可以分为重度，中度，轻度，不同程度也有较明显的临床及胸部CT影像学特点。结论这种结合临床的胸部CT影像学分期对于确定肺挫伤的病程阶段和针对不同阶段采取积极有效的治疗措施，益于肺挫伤患者的早日恢复。

Objective To determine pulmonary contusion＇ s different clinical process stages by analyzing patient＇ s clinica symptoms and the series of chest CT scan results. Methods A retrospective analysis of 351 cases of pulmonary contusion was performed to identify the clinical relevant outcomes and classification of pulmonary contusion between June 2006 and June 2009 in Department of Cardio-thoracic surgery, the Affiliated Hospital of the Medical College of the Chinese People＇ s Armed Police Forces. The clinical charts and a total of 1228 series of chest CT scan results were included in the analysis. Results Acute trauma stage, pulmonary effusion stage, thoracic effusion stage, and recovering stage were classified based on the clinical pathophysiologic process and the series of thoracic CT scan study, because each period carries its own typical thoracic CT scan image character associated with its respective clinical symptom which can be determined to set a pinpointed treatment to it. Conclusion The classification and the pinpointed treatment offered to each specific stage are considered as reliable methods for the thoracic traumatic patients suffering from pulmonary contusion.