【摘要】 目的研究重症腺病毒肺炎患儿临床特点及CT诊断结果。方法将我院2016.12至2017.12间收治的154例腺病毒肺炎患儿纳为研究对象,分析临床表现及其CT诊断特征。结果①腺病毒肺炎患儿男女比例为1.96:1,年龄集中在6个月-2岁(79.22%),发病季节集中在春冬季(71.43%),治疗效果一般较好;主要临床症状有发热、咳嗽、气喘等,89.64%与61.04%的患儿存在肺部湿罗音与肺部哮鸣音;实验室检查提示86.36%的患儿肌酶谱升高,50.65%CRP升高,40.26%WBC升高;②将患儿分为普通组(普通型腺病毒肺炎,n=104)与重症组(重症腺病毒,n=50),重症组与普通组患儿X线片均有双肺纹理改变、肺气肿、小叶实质浸润等病变,但重症腺病毒肺炎患儿肺气肿、单侧实变分布、肺段及大叶实质浸润情况均较普通腺病毒肺炎患儿严重;重症组与普通组患儿胸部CT检查均有肺实质改变、双肺受累、实变向心性分布、小气道改变等,但重症腺病毒肺炎患儿双肺受累、受累肺叶数≥3、实变向心性分布、团簇状影、支气管充气征、小气道改变程度及胸膜增厚情况均较普通组严重。结论重症腺病毒感染X线片以肺间质改变、实变、小叶实质浸润与肺段及肺叶实质浸润居多,CT以双肺多发团簇状实质为特点,病变密度多较高,具有边缘模糊、强化均匀的特点,且多呈向心性分布,且小气道改变情况较为严重。更多还原

【Abstract】 Objective To study the clinical characteristics and CT diagnosis results of children patients with severe adenovirus pneumonia. Methods A total of 154 children patients with adenoviral pneumonia admitted to our hospital from December 2016 to December 2017 were included in the study. The clinical manifestations and CT diagnostic features were analyzed. Results The ratio of male to female in children patients with adenovirus pneumonia was 1.96:1, and the age was concentrated in 6 months to2 years(79.22%), and the onset season was concentrated in spring and winter(71.43%),and the treatment effect was generally good. The main clinical symptoms were fever,cough and asthma, and 89.64% and 61.04% children patients had lung wet rales and lung wheezing rales. Laboratory tests showed that 86.36% children patients had elevated muscle zymogram, and 50.65% with increased CRP and 40.26% with elevated WBC. Children patients were divided into general group(general adenovirus pneumonia, n=104) and severe group(severe adenovirus pneumonia, n=50). X-ray films of severe group and general group were with lung texture changes, emphysema and lobular parenchymal infiltration, but the emphysema, unilateral consolidation, lung segment and large leaf parenchymal infiltration in children patients with severe adenovirus pneumonia were more severe than those in children patients with general adenovirus pneumonia. Chest CT examinations of severe group and general group showed lung parenchyma changes, double lungs involvement, consolidation and centripetal distribution and small airway changes.However, the double lungs involvement, involved lung lobes ≥3, and consolidation and centripetal distribution, cluster-like shadow, air bronchogram, small airway change and pleural thickening in children patients with severe adenovirus pneumonia were more severe than those in general group. Conclusion X-ray films of severe adenovirus infection have pulmonary interstitial changes, consolidation, lobular parenchymal infiltration and infiltration of lung and lobes. CT is characterized by multiple cluster-like parenchyma of double lungs, and the parenchyma have high density, fuzzy edges and uniform enhancement, and they are mostly distributed in a centripetal manner, and small airway changes are more serious.更多还原