小儿溺水的肺部X线表现(附12例报告)  

X ray Finding of the Lung in Children Near Drowning: Report of 12 Cases

作　　者：李东辉[1] 徐赛英[1] 罗平风[1] 孙国强[1] 曾津津[1] 

机构地区：[1]北京儿童医院放射科

出　　处：《临床放射学杂志》1997年第4期240-242,共3页Journal of Clinical Radiology

摘　　要：目的：提高对溺水儿童肺部Ｘ线表现的认识。材料与方法：１２例溺水儿童，溺于清水中８例，污水３例，养鱼池１例。离水时７例呼吸心跳停止，５例有微弱呼吸。１２例于离水后２～２０小时摄首次胸片，１～３天复查７例，７天复查２例。结果：（１）首次胸片表现：①肺纹理增多１２例，其中１例见“双轨征”；②肺内小片影５例；③肺内广泛分布絮状、小结节状、斑片状阴影５例；④不同程度肺气肿１１例。（２）肺内病灶变化情况：①６例病灶于１～３天明显吸收；②１例病灶进行性增多，出现多发肺脓肿。结论：溺水患儿的肺部Ｘ线表现包括：（１）早期阴性或迟至２４小时出现病灶；（２）肺水肿征象；（３）吸入性肺炎征象；（４）气道内异物征象；（５）气道梗阻征象；（６）合并感染征象；Objective: To improve the recongnition of chest radiographs of near drowned children.Materials and Methods:Twelve children had near drowned, among them 8 in fresh water, 3 in filthy water, and 1 in fishpond. While they left the water, 7 cases were breath and cardiac arrest, 5 were faint breating. After 2 to 20 hours of leaving the water, 12 cases had taken the initial chest film. 7 cases had taken second film on 1 to 3 days later, 2 had taken it on 7 days later. Results:(1) The initial film showed: ① the lung markings increased in 12 cases and 1 of them showed orbit sign; ② tonical fluffy lesions were in 5; ③ diffuse fuzzy, nudular lesion and confluent density were seen bilaterially in 5; ④ different degrees of emphysema were in 11. (2) The foci in the lung were exchanged rapidly :① in 6 cases the foci were absorbed obviously in 1 to 3 days; ②in 1 case the focus were increased progressively and showed mutiple pulmonary abscess.Conclusion: The X ray finding of the lung in children near drowning included: (1) initial normal or the focus occurs after 24 hours of leaving water; (2) the sign of pulmonary edema; (3) the sign of aspiration pneumonia; (4) the signs that foregn body pack with air way; (5) the signs of air way obstruction; (6) the sign of complicating infection. and (7) the signs of iatrogenic injury.

关 键 词：溺水 肺水肿 X线 儿童 

分 类 号：R726.493[医药卫生—儿科] R725.416.3[医药卫生—临床医学]