螺旋CT在百草枯中毒肺损害中的价值

The value of Spiral CT in the lung damage of paraquat poisoning

目的:探讨百草枯中毒肺损害CT表现及演变过程。方法:回顾性分析18例患者的CT及临床资料。结果:18例患者肺部CT表现、肺外合并症与中毒剂量、检查时间相关。剂量小时肺部损害程度轻,剂量大时肺部损害程度重;随检查时间不同出现以下CT改变:早期(≤7d),以肺周边分布为主的磨玻璃、实变影,同时伴肺过度通气;中期(7～14d),磨玻璃影、肺实变有逐渐吸收、范围缩小趋势;晚期(≥14d),以肺间质纤维化为主要表现。结论:百草枯中毒时肺实质、肺间质均受累,早中期以肺实质损害为主要CT表现,晚期以肺间质损害为主要CT表现。CT扫描有助于观察肺损害的程度、演变,有助于显示肺外合并症,对判断预后、制订治疗方案有帮助。

Objective：To explore the CT performance and evolution of lung damage poisoned by paraquat.Methods：CT and clinical data of 18 patients with lung damage poisoned by paraquat were retrospective analysised.Results：The lung CT performance and extrapulmonary complications of 18 patients were related to toxic dose and checking time.The lung damage was light with small dose and the damage was serious with large dose.The following CT manifestations were found in different cheching time：early stage（≤7 days）,the performance is ground-glass and pulmonary consolidation shadow with pulmonary peripheral distribution and pulmonary hyperventilation;middle stage（7-14 days）,ground-glass and pul monary consolidation shadow had a trend of absorbing and reducing;later stage（≥14 days）,the main performance was pulmonary interstitial fibrosis.Conclusion：The pulmonary parenchyma and pulmonary interstitial are both involved with paraquat poisoning.Pulmonary parenchyma damage is CT performance at early and middle state.While pulmonary intersti tial damage is CT performance at later stage.CT scanning helps to observe the extent and evolution of lung damage,show the extrapulmonary complications and judge the prognosis and formulate therapeutic schemes.