三氯甲基碳酸酯吸入中毒的临床及肺部影像表现  

Clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning

作　　者：叶彩儿[1] 叶民[2] 陈伟建[1] 刘再毅[3] 吴恩福[1] 杨运俊[1] 

机构地区：[1]温州医学院附属第一医院影像科,325000 [2]温州医学院附属第一医院呼吸内科,325000 [3]广东省人民医院影像科

出　　处：《中华放射学杂志》2007年第11期1183-1185,共3页Chinese Journal of Radiology

摘　　要：目的探讨三氯甲基碳酸酯吸人后的临床及肺部影像表现。方法回顾分析因三氯甲基碳酸酯泄漏吸人中毒17例患者的临床及肺部影像表现,并结合实验室检查指标,对三氯甲基碳酸酯损害肺部程度、进展及恢复情况进行探讨。结果 5例轻症患者,X 线与 CT 仅表现为两肺野散在少许斑片影;12例中、重症患者中3例以两肺多发小片状、结节影为主,病灶部分融合;9例累及全肺,表现为两肺广泛分布的大小不等的类圆形结节影及小灶不规则模糊增密影,部分融合,伴有小叶间隔及支气管壁增厚。影像与临床表现、实验室检查结果相符合。结论三氯甲基碳酸酯吸人后,肺部 X 线片与 CT 可观察肺部病变、肺水肿程度、进展及恢复情况,可协助临床早期治疗及评价疗效。Objective To examine the clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning. Methods Clinical manifestations, laboratory tests and CT scans were analyzed retrospectively in 17 patients with triphosgene poisoning. We focused on the severity, development and repair of pulmonary impairment. Results Plain film and CT scans in five mild cases demonstrated bilateral scattered pulmonary patchy shadows. Of 12 cases with moderate to severe diseases, three showed bilateral multiple pulmonary patchy shadows and nodules with confluence of part of the lesions on plain film and CT scans; bilateral lungs were involved in nine cases with imaging findings of bilateral disseminated pulmonary round or ovary nodules with different size, ill-defined and partly-confluent patchy shadows and thickening of both interlobular septum and the wall of bronchus. Of clinical interests, imaging findings were closely correlated with chnical course and laboratory results. Conclusion Radiological examinations with plain films and CT scans could reveal the severity, evolvement of pulmonary edema in patients with triphosgene poisoning, and these are of clinical benefit in the early management and prognostic evaluation of patients with tripbosgene poisoning.

关 键 词：气体中毒 肺水肿 放射摄影术 体层摄影术 X线计算机 

分 类 号：R595[医药卫生—内科学] R816.4[医药卫生—临床医学]