飞利浦64排螺旋CT对不同大小肺结节的诊断效能分析

目的探讨与分析飞利浦64排螺旋CT对不同大小肺结节的诊断效能,以促进飞利浦64排螺旋CT的应用。方法选择2017年8月—2022年3月在北京市丰台中西医结合医院诊治的大小肺结节患者86例,其中直径≤1 cm的肺结节40例(小结节组),直径1~3 cm的肺结节46例(大结节组)。所有患者均给予飞利浦64排螺旋CT检查,记录两组常规CT特征、CT值、CT灌注参数,结节恶性率并判断诊断价值。结果大结节组的空气支气管征、胸膜牵拉征、空泡征、血管聚集征、分叶征、毛刺征等CT特征占比分别为80.43%、86.96%、89.13%、84.78%、89.13%、80.43%,均显著高于小结节组的30.00%、35.00%、45.00%、52.50%、35.00%、50.00%(P<0.05)。大结节组的CT值均明显高于小结节组(P<0.05)。大结节组的支气管动脉灌注值、肺动脉灌注值均明显高于小结节组(P<0.05),两组灌注指数比较差异无统计学意义(P>0.05)。大结节组的恶性率为80.43%(37/46),其中,腺癌20例、鳞癌13例、小细胞癌4例,小结节组的恶性率为30.00%(12/40),其中,腺癌6例、鳞癌4例、小细胞癌2例,两组比较差异有统计学意义(P<0.05)。结论飞利浦64排螺旋CT在不同大小肺结节的应用能通过影像学形态特征与灌注特征,反映结节的病理状况,具有很好的诊断效能,能够为不同大小的肺结节定性诊断提供帮助。

Bradycardia Secondary to Negative Suction Pressure Applied to Chest Drain

Positive pressure generated in peritoneal cavity by gas insufflation during laparoscopic procedures can cause hemodynamic instability. There are a few case reports suggesting similar occurrences during thoracoscopic procedures as well. The mechanism behind the conditions above is explained to be due to stretch force applied to peritoneum and pleura which causes vagal stimulation. We wish to present a case where a high negative pressure applied to pleural cavity lead to treatment-resistant bradycardia. The possible mechanism behind this occurrence was traction pressure on pleura which triggered vagal activity. The bradycardia subsided on reducing or discontinuing negative suction pressure. To best of our knowledge this the first case report on bradycardia associated with high negative suction pressure applied to inter costal drain.