儿童肺炎影像表现与病原学相关因素的分析

Analysis on Related Factors of Imaging Manifestation and Etiology in Children Pneumonia

目的探讨不同病原体感染儿童肺炎的影像表现,为临床早期判断肺炎病原体提供诊断依据。方法对673例经实验室病原检测为肺炎阳性患儿的影像学(X射线、CT)表现及病原学资料进行综合分析、总结、归类。结果支原体肺炎主要影像表现肺叶、段实变193例、支气管肺炎167例;链球菌肺炎主要影像表现肺叶、段性实变62例;金黄色葡萄糖球菌肺炎主要影像表现肺叶、段实变33例、肺脓肿9例、肺气囊形成23例、坏死21例;大肠杆菌肺炎主要影像表现支气管肺炎31例;克雷伯杆菌肺炎主要影像表现大叶性肺实变16例、肺脓肿9例;腺病毒肺炎主要影像表现广泛肺浸润32例;呼吸道合胞病毒肺炎主要影像表现毛细支气管炎28例。结论根据不同病原体儿童肺炎的影像学特点,可以全面、准确地评估儿童肺炎病原体类型,为临床诊疗提供有力依据。

Objective To explore the different pathogen imaging findings of pneumonia in children and provide a ba sis tbr early diagnosis of pneumonia pathogens. Methods Pneumonia possitive image manifestations （x - ray, CT） and the etiological data were analyzed, summarized and classified for 673 cases of pneumonia positive comfirmed by laboratory, etiological deteition. Results 193 cases had the main manifestations of mycoplasma pneumonia： lobe,segment consolidation, 167 ca-ses of bronchial pneumonia; 62 cases with streptococcus pneumoniae mainly manifested by lobar, segmental consolidation; 33 cases with staphylococcus aureus pneumonia glucose mainly manifested by lobe, segment consolidation, 9 cases of lung ab scess, puhnonary balloon formation in 23 cases, necrosis in 21 cases; E. coil pneumonia just imaging findings： 31 cases of bronchial pneumonia; Klebsiella pneumoniae mainly manifested by lobar lung consolidation, 9 cases of lung abscess; 32cases with ADV pneumonia maily manifested by extensive pulmonary infiltrates; 28 cases with RSV syncytial virus pneumonia mainly manifested by bronchiolitis. Conclusion Pneumonias caused by different pathogens all have their obvious imaging characteris tics which can be taken as one of the most imt3ortant evidences for early diaanosis of t）neumonia oathoens.