煤矿工人肺爆震伤的影像分析

【摘要】目的探讨煤矿工人肺爆震伤的影像表现特征，以为临床诊断和治疗提供参考。方法回顾分析78例肺爆震伤的临床资料和影像表现。结果爆震伤肺部影像表现复杂多样，检查时间不同可出现不同影像表现。11例24h内X线和CT影像无异常者3d内出现异常，53例x线和CT影像异常者3d内影像表现加重，8例复查减轻。78例X线和（或）CT影像表现为毛玻璃样改变15例，间质型13例，节段实变型24例，弥漫实变型26例。出现气胸35例，胸腔积液28例，并发肋骨骨折24例。27例继发肺部感染。结论影像学检查是诊断肺爆震伤的重要依据，对病变的显示cT优于x线平片，在条件允许情况下应尽早行胸部CT检查。

Objective To investigate the imaging features of burst injury of the lung in coal miners and to provide reference for clinical diagnosis and treatment.Methods A retrospective analysis was performed on the clinical data and imaging findings of 78 patients with burst injury of the lung.Results The imaging findings of burst injury of the lung were variable and complex,and they varied over time.Eleven cases showed no abnormalities on X-ray and CT within 24 h,but abnormalities appeared within 3 d; 53 cases showed abnormalities on X-ray and CT and had an exacerbation within 3 d; 8 cases showed improvements when reexamined.Among the 78 patients examined by X-ray and (or) CT,ground glass-like shadows were noted in 15 cases,interstitial changes in 13 cases,segmental consolidation in 24 cases,and diffuse consolidation in 26 cases.The complications included pneumothorax (n =35),hemothorax (n =28),costal fracture (n =24),and pulmonary infection (n=27).Conclusion X-ray plain film and CT offer a reliable basis for early diagnosis of burst injury of the lung.CT is superior to X-ray plain film in detecting lesions,so chest CT should be performed as early as possible to remedy burst injury of the lung.