危重型新型冠状病毒肺炎的床边胸部DR动态表现

Dynamic radiological features of bedside DR of critical COVID-19

目的:探讨危重型新型冠状病毒肺炎(简称新冠肺炎)床边胸部DR的动态表现。方法:回顾性分析我院收治的87例危重型新冠肺炎患者的临床及影像资料。对床边DR按时间段进行描述分析。结果:87例中,男64例,女23例;年龄37~89岁,中位年龄66岁;合并基础疾病56例,其中以高血压最常见。实验室检查C反应蛋白升高及淋巴细胞减少多见。2例出院,69例住院(15±8)d后死亡。87例均为双肺受累,影像表现以实变影及实变混合纤维网格影为主。住院1~3 d以实变影为主,但磨玻璃影为所有时间段内比例最高;4~6 d磨玻璃影明显减少,实变及纤维网格影增多;7~9、10~12、>12 d均以实变、实变与纤维网格影混合为主。各时间段DR评分均>21分,且经过治疗后DR评分变化不大。结论:床边DR是一种针对危重型新冠肺炎的可行的影像学评价方法,其动态表现提示危重症患者病变严重且持续。

Objective:To explore the dynamic imaging performance of bedside chest radiography of critical COVID-19 patients.Methods:Retrospective analysis of clinical and imaging data of patients with critical COVID-19 admitted to ICU of our hospital from February 1 to March 18,2020.The image data of all patients were analyzed at different time periods.Results:87 patients were enrolled,with a median age of 66 years and 56 cases combined with underlying disease,of which 44 cases were hypertension.Increased C-reactive protein and decreased lymphocytopenia were common in laboratory tests.Two patients were discharged after treatment,and 69 died after(15±8)d of hospitalization.All 87 patients had bilateral lung involvement,and the imaging manifestations were mainly consolidation and consolidation mixed fiber grid shadows.1~3 d of hospitalization were dominated by consolidation,but ground glass was the highest proportion of all time periods.Ground glass was significantly reduced in 4~6 d,and consolidation and fiber grid shadows were increased.7~9 d,10~12 d and>12 d were dominated by consolidation and consolidation with fiber grid shadow.The DR score was greater than 21 points in each time period,and the DR score did not change much after treatment.Conclusions:Bedside DR is a feasible imaging evaluation method for critical COVID-19,and its dynamic manifestations suggest that critically ill patients have severe and persistent damage.