青年人肺下野结核病理演变及X线特点研究

X-ray features and pathdogical changes of inferior lung tuberculosis in young patients

目的:探讨青年人肺下野结核病理演变及X线特点。方法:搜集资料完整的青年人肺下野结核68例,全部病例摄有2次以上不同时期胸片对比,观察病灶病理演变及X线特点。结果:根据病理改变的不同X线表现分别为:①大片云絮状阴影或散在分布小斑片状阴影28例(41.18%);②结节状阴影6例(8.82%);③椭圆形或团块状影6例(8.82%);④纤维索条状影或斑点状、斑片状钙化影7例(10.30%);⑤空洞性改变7例(10.30%);⑥肺段或肺叶大片状阴影9例(13.23%);其他:蜂窝状阴影2例,粟粒状阴影3例共5例(7.35%)。结论:青年人肺下野结核与肺上野结核表现形式不同。青年人肺下野结核病理演变过程中,较少出现增殖性改变。渗出性病变或干酪性肺炎只不过是青年人肺下野结核病理演变过程中的不同阶段,早期为渗出性结核性肺泡炎,进展恶化则形成干酪性肺炎。X线特点:广泛性、多样性、可变性、单侧性、混合性、肺门区病灶痰阳现象。

Objective To discuss the X-ray feature and pathological changes of inferior lung field tuberculosis in young patients.Method 68 cases were all cases of photo chest X-ray contrast of the different periods of more than 2 times.Observed the evolution of the lesion pathology and X-ray features.Results According to the process of change the X-ray manifestations were summarized as follows：①Large cloud or mottled shadows,28cases（41.18%）;②Nodular,6cases（8.82%）;③Oval or massive shadows,6cases（8.82%）;④Fiberlinear shadows or spotty calcifications,7cases（10.30%）;⑤Cavitry changes,7cases（10.30%）;⑥Large patchy shadows in segment or lobe of lung,9cases（13.23%）;⑦The other（7.35%）：Honeycomb,2cases;and,granular,3cases.Conclusion Inferior lung field tuberculosis is different form that of superior one.In the process of pathological changes proliferation less frequent.Exudation of caseous pneumonia is simply the different stages of the development of tuberculosis.The early stage is exudative tuberculosis alveolitis.Its further deterioration led to caseous pneumonia.X-ray Feature：①Extensive;②Various;③Changable;④Unilateral;⑤Mixed form;⑥Hilar smear positive.