急性硫化氢气体中毒的肺部影像学表现

The Pulmonary Imaging Manifestations in Patients with Acute Hydrogen Sulphide Gas Poisoning

目的探讨急性硫化氢(H2S)气体中毒的肺部影像学表现,为临床治疗提供参考依据。方法观察5例急性中、重度H2S中毒患者的胸部X线及CT表现,以及治疗过程中的变化。结果胸部X线示两肺透亮度减低,双侧肺纹理增粗由肺门向周围肺野放射性分布,并见密度较淡的斑片影。胸部CT示两肺弥漫性分布斑片状影及磨玻璃样密度影,以外周带为主,并见少量结节影及索条状影。治疗7天后肺部病变吸收明显,27天后病变基本吸收,仅1例可见残留腺泡结节样磨玻璃密度影。结论了解H2S中毒患者肺部影像学表现及其转归,可为临床治疗提供有价值的依据,并对肺部损害的严重程度作出判断。

Objective To investigate pulmonary imaging manifestations in patients with acute hydrogen sulphide gas poisoning in order to provide useful reference for clinical treatment. Methods Chest X-ray and thoracic CT findings in 5 patients with acute moderate-to-severe hydrogen sulfide gas poisoning were retrospectively analyzed, and the changes of imaging during the treatment course were recorded. Results Chest X-ray imaging showed that decreased transparency was seen in both lung, and thickened bilateral lung markings and patchy low-density shadow could be found. Chest CT scanning revealed that diffuse distribution patchy pulmonary effusion together with ground glass opacity, mainly located at the peripheral zone, and the small nodules with fibrosis could be seen in the lung field. After treatment for 7 days the abnormal lung shadows were obviously absorbed, and 27 days after the treatment the pulmonary lesions were basically absorbed. Some visible residual acinar nodules of ground glass density were observed in only one case. Conclusion Full understanding of the lung imaging appearances and their changes during treatment course in patients with acute hydrogen sulphide gas poisoning is very important for the evaluation of the severity of lung damage.