高血压脑出血患者肺部感染CT影像学特点及治疗

CT Imaging Features and Treatment of Pulmonary Infection in Patients with Hypertensive Cerebral Hemorrhage

目的回顾性分析高血压脑出血患者肺部感染CT影像的特点,指导临床治疗。方法回顾性分析该院2018年1月—2019年12月收治的高血压脑出血患者345例,其中并发肺部感染患者97例,分析肺部感染患者胸部CT影像学特点,分析出血与肺部感染的关系。结果脑出血患者肺部感染胸部CT以双肺下叶坠积性改变为主,包括胸腔积液、肺不张、肺实变,早期3 d内改变主要与呕吐误吸、神经源性肺水肿有关,偏瘫侧坠积性改变情况更重于健侧。结论肺部感染是脑出血常见严重并发症之一,严重影响患者预后,CT首先主要表现为坠积改变,后继发感染,偏瘫侧肺部坠积性改变重于健侧,因此提醒临床治疗过程中注意,早期3 d内注意恶心呕吐、吞咽困难、误吸,更要重视偏瘫侧的坠积性改变。

Objective To retrospectively analyze the characteristics of CT images of lung infection in patients with hypertensive cerebral hemorrhage and to guide clinical treatment.Methods A retrospective analysis of 345 patients with hypertensive cerebral hemorrhage admitted to the hospital from January 2018 to December 2019,including 97 patients with pulmonary infection,analysed of chest CT imaging characteristics of patients with lung infection,analysed of bleeding and lungs infected relationship.Results Chest CT of lung infection in patients with cerebral hemorrhage was mainly characterized by the fall of the lower lobes of the lungs,including pleural effusion,atelectasis,and lung consolidation.The changes in the early 3 d were mainly related to vomiting,aspiration,and neurogenic pulmonary edema changes.And later complicated by bacterial infections.Among them,there were differences in the changes of bilateral lungs,and the changes of falling down on the hemiplegic side were more serious than those on the healthy side.Conclusion Pulmonary infection is one of the common serious complications of cerebral hemorrhage,which seriously affects the prognosis of patients.CT firstly manifests as drop accumulation changes,followed by secondary infections.The hemiplegic side lungs drop accumulation changes are more important than the healthy side,so it calls attention during the clinical treatment process,pays attention to nausea,vomiting,dysphagia and aspiration in the early 3 d,and pays more attention to the hemiplegic side changes.