急性硫化氢中毒肺损伤CT评分与氧合指数相关性研究  

The correlation between CT score of lung injury and oxygenation index in patients with acute hydrogen sulphide poisoning

作　　者：杨志辉 许永明 江晓勇 林建军 王德顺 陈宇雷 赵海玲 

机构地区：[1]浙江省温岭市第一人民医院CT室,317500 [2]浙江省温岭市卫生监督所

出　　处：《中华劳动卫生职业病杂志》2017年第9期691-694,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨急性硫化氢中毒后各时期肺损伤的CT评分与氧合指数的相关性，为CT评分是否能应用于急性硫化氢中毒后急性肺损伤的评定提供依据和参考。方法纳入32例符合课题要求的急性中重度硫化氢中毒患者，按GBZ31-2002《职业性H2s急性中毒诊断标准》分成中度组和重度组，以发病后一系列胸部影像和临床资料作为研究资料进行回顾性分析。参考改良肺损伤评分标准中的胸片评分标准提出CT评分标准；分析中度组、重度组在急性期与消散期的CT评分和氧合指数有无差异；分析急性硫化氢中毒后肺损伤CT评分值和氧合指数的相关性。结果急性期和消散期中度中毒组CT评分分别为2．26±1．37，1．34±0．65；均低于重度中毒组（10．44±2．55，4．55±2．45），差异均有统计学意义（均P〈0．05）。急性期19例和消散期8例中度中毒组氧合指数分别为307．55±28．29，435．75±37．00；急性期9例和消散期9例重度中毒组氧合指数分别为193．17±36．41，347．67±44．49。急性期和消散期的重度中毒组氧合指数均低于中度中毒组，差异有统计学意义（均P〈0．01）。Pearman相关分析结果显示，急性期和消散期CT评分与氧合指数呈负相关（r=-0．97、-0．75，均P〈0．01）。结论急性硫化氢中毒后肺损伤的CT评分与氧合指数呈负相关，CT评分能够较好的反映肺损伤的程度，可以应用于急性硫化氢中毒后急性肺损伤的评定。Objective To explore correlation between chest CT score and oxygenation index in patients with acute hydrogen sulphide poisoning, whether CT score can be applied to assess acute lung injury after acute hydrogen sulfide poisoning and provide basis and reference. Methods The clinic and a series of CT datas of 32 acute hydrogen sulphide poisoning cases were retrospectively analysed and compared, According to GBZ31-2002 （the diagnostic standard of occupational H2S acute poisoning）, these patients were divided into 2 grouds including moderate groud and severe groud ; The CT score were improved, referenceing the scoring criteria of the chest X-ray; The difference of the CT score and the oxygenation index were analyzed between moderate and severe group in the acute phase and the disperse phase ; The correlation between CT score and oxygenation index were analyzed. Results The CT score in moderate poisoning group were lower than severe group （2.26±1.37 vs 10.44±2.55, 1.34±0.65 vs 4.55±2.45, all P〈0.05） in the acute phase and the dissipation phase.The oxygen index of the 19 cases in the acute phase were 307.55 ±28.29, and the oxygen index of the 8 cases in the dissipation phase was 435.75±37.00; The oxygen index of the 9 cases in the acute phase and the dissipation phase were respectively 193.17±36.41, 347.67±44.49. The oxygen partial pressure and oxygenation index in severe group were significantly lower than those in moderate group （all P〈0.01 ） in the acute phase and the dissipation phase. Pearman correlation analysis showed that the CT score were negatively correlated to the oxygen index in the acute phase and the dissipation phase, respectively （r=-0.97 ,-0.75, all P〈0.01 ）. Conclusions The CT score of lung injury and oxygenation index is negatively correlated. The CT score can be used to evaluate the degree of lung injury, and can be used in the evaluation of acute lung injury after acute hydrogen sulfide poisoning.

关 键 词：硫化氢 中毒 呼吸窘迫综合征 体层摄影术 X线计算机 

分 类 号：R135.14[医药卫生—劳动卫生]