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1、迟发性肺挫伤的CT表现及其动态变化【摘要】目的探讨CT对迟发性肺挫伤的诊断意义及其动态表现，为临床及时准确治疗提供可靠的诊断依据。方法分析150例迟发性肺挫伤的CT和临床资料，对迟发性肺挫伤与发生时间、发生部位、与既往肺部疾病以及迟发性血胸的相关性进行研究，对迟发性肺挫伤的CT表现及其动态变化等进行分析。结果根据CT表现将迟发性肺挫伤分为：分支型51例：病灶沿支气管分布,呈分支状;粗大条索型40例：表现为肺外带粗大条索状高密度影，长短不一;絮带型33例：挫伤病灶沿肺叶边缘分布，表现为沿两肺外带絮带状高密度影;新月型26例：表现为下叶背部近胸膜下新月状毛
2、玻璃样密度影，大都单侧发生。迟发性肺挫伤大都于伤后24h后～48h内发生，达62.00%(93/150)，与伤后～24h内以及48h后～72h内比较差异有极显著性意义(P<0.0001);大都发生在右肺，占64.97%(97/150)，与发生在左肺比较，差异有极显著性意义(P<0.0001)，发生在下叶的迟发性肺挫伤又比上叶明显多见，差异也有极显著性意义(P<0.0001)。结论CT不仅能及时发现迟发性肺挫伤，还可对发生的部位、性质、损伤程度、并发症以及预后等做出及时判定，为临床及时准确治疗提供可靠的诊断依据;应将伤后48hCT复查列
3、为常规;迟发性肺挫伤不易完全吸收，易遗留肺纤维化及胸膜增厚、粘连。【关键词】肺挫伤，迟发性;体层摄 影术，X线计算机11 [Abstract]ObjectiveToexplorethevalueoftheComputedTomography(CT)scannedimagesandthedynamicchangeindiagnosisofpulmonarycontusion.Methods150patientswithpulmonarycontusionwereanalyzed.TheCTimageandtheclinicaldatawascollec
4、ted,andanalyzedthecorrelativitybetweendelayedpulmonarycontusionandtheoccurredtime,theposition,previouslylungdiseaseorthedelayedhemopneumothorax.TheCTmanifestationandthedynamicchangeofthedelayedpulmonarycontusionwasanalyzedsimultaneously.ResultsAbout62%(93/150)ofpulmonarycontusio
5、ncaseswereoccurredin24Hto48Hafterchestinjured,thereweresignificantdifferencesbycomparedwithbefore24Hand48Hto72H,respectively(P<0.0001).Majorityofcaseswereoccurredinipsilateral,which8%caseswereoccurredincontralateral.About70%ofpatientswereinjuredbytrafficaccident,andmajorityof
6、pulmonarycontusioncases(74.67%)wasoccurredinclosed-chestinjury.Rightlunginjury(64.97%)wasprevalent,andhaveasignificantdifferencesbycomparedwiththecasesofinleftlung.Thereweremoredelayedpulmonarycontusioncasesinbothsidesoflowerlobulethantheupperlobule,alsohaveasignificantdifferenc
7、es.AccordingtotheimagecharacteristicofCTs,allofimageweredividedintothreetype11as:floccules-striptype,branchtypeandcrescent-shapedtype.ConclusionThespiralCTscancannotonlyfindoutthepulmonarycontusioncasesopportunely,butalsocanestimatetheinjuryposition,character,degree,complication
8、andprognosis,whichasadiagnosedevidencefortreate
