【摘要】 目的:探讨急性有机氟吸入中毒患者的胸部CT表现及特点,并从毒理学上对CT征象进行分析。方法:19例急性有机氟吸入患者在出现中毒症状后立即进行常规CT或HRCT检查,扫描范围从肺尖至膈肌;早期CT复查每隔3天进行,后期CT复查每月进行,当出现与治疗有关的并发症如脂肪肝或股骨头坏死时同时对相应器官进行CT检查。结果:急性有机氟中毒胸部CT类型可分急性期(或水肿期)和恢复期(或间质纤维化期)。CT表现多种多样,包括肺泡性和/或间质性肺水肿,肺实变,肺间质性病变,胸膜下结节灶和胸腔积液等,随着病程的进展出现各种形态的肺纤维化和胸膜增厚等改变。与大剂量激素治疗有关的并发症主要为脂肪肝和股骨头无菌性坏死,尤其是后者的发生率在本组存活病例中达到100%。结论:根据急性有机氟吸入中毒患者的胸部CT表现结合有机氟吸入史,可做出早期诊断并指导临床治疗。更多还原

【Abstract】 Objective:To discuss the chest CT appearances and characteristics in patients with acute inhalation of vaporized organic fluorides. Methods:19 cases of patients with acute inhalation poisoning of vaporized organic fluorides underwent conventional CT and high resolution CT (HRCT) examinations immediately after onset of intoxication symptoms. CT scans ranged from the lung apex superiorly to the diaphragm inferiorly. Repeated CT was done every 3 days initially and monthly late in the disease process as follow-up. The liver and the pelvis were also included in the follow-up CT examinations should treatment-associated complications such as fatty liver or ischemic necrosis of the femoral head be suspected.Results:In patients with acute inhalation of vaporized organic fluorides, CT showed acute phase (or edema phase) and convalescence phase (or interstitial fibrosis phase),CT demonstrated varying degree of pulmonary changes such as alveolar and/or interstitial lung edema.Lobar or segmental consolidation and interstitial lesions as well as subpleural nodules and pleural effusions. Pulmonary fibrosis and pleural thickening occurred as late consequences along with the disease process. Complications related to administration of large-dose cortisones included fatty liver and ischemic necrosis of the femoral head, especially the latter being the gravest with an occurrence rate of 100% in the alive patients.Conclusion:The diagnosis of acute inhalation injury of the lung from vaporized organic fluorides can be reached according to the chest CT appearances and the inhalation history, which in combination helps the physicians to adopt an emergent and proper treatment.更多还原