【摘要】 目的分析急性重症胸部创伤后肺内损伤与肺外解剖结构损伤的急诊CT表现,提高其临床治疗价值。方法对严重胸部外伤或复合伤后接受胸部CT检查并住院治疗的96例患者的CT影像资料及临床相关资料进行回顾性分析并分类。结果 (1)肺内损伤的CT表现:①肺间质异常18例;②磨玻璃样肺32例;③肺叶实变16例;④肺叶、段萎陷伴胸腔积液或气胸16例;⑤肺气囊或液气囊14例。(2)肺外表现:①肋骨骨折96例,其中单侧单发或多发肋骨骨折67例,双侧多发肋骨骨折29例;②胸腔积液67例,其中单侧胸腔积液43例,双侧胸腔积液24例;③气胸、液气胸38例,其中单侧气胸29例,双侧气胸9例;④皮下或纵隔气肿14例。(3)46例胸廓多发损伤、42例合并颅脑损伤。对肺内损伤呈多样表现且治疗时间在2周以上,较其它类型差异有统计学意义(P<0.05)。结论胸部重症创伤的CT表现以复合伤为主,CT检查有助于肺内外各解剖结构损伤程度评价,具有十分重要的临床意义。更多还原

【Abstract】 Objective To explore the emergency CT manifestations of intrapulmonary injury and extrapulmonary anatomical structure damage to raise diagnosis value. Methods We collected and reviewed and classified the CT images and clinical information of 96 cases of serious chest trauma or multiple injuries undergoing chest CT examination after the hospitalization. Results (1)The CT findings of intrapulmonary included ①18 cases of interstitial lung abnormalities; ②32 cases of ground-glass-like lung; ③16 cases of lung consolidation lesion; ④ 16 cases of lobe and segment collapse with pleural effusion or pneumothorax; ⑤14 cases of traumatic pul-monary pseudo-cysts with thin walls or irregularwalls and ground-glass shadows.(2)The extrapulmonary manifestations included ①96 cases of rib bone fractures,in which 67 cases were single or multiple unilateral rib fracture and 29 cases were bilateral multiple rib fractures; ② 67 cases of pleural effusion,in which 43 cases were unilateral pleural effusion and 24 bilateral pleural effusion; ③38 cases of pneumothorax and pneumothorax fluid,in which 29 cases were unilateral pneumothorax and 9 cases bilateral pneumothorax; ④ 14 cases of subcutaneous emphysema or mediastinal emphysema.(3)When patients were discharged from hospital,46 cases were bone fractures severity of thoracic trauma and 42cases were simultaneously craniocerebral injuries. Conclusion The CT examination can show intrapulmonary and extrapulmonary anatomical structure damage in severe chest trauma,which has an important clinical sig-nificance.更多还原