2019新型冠状病毒肺炎重症病区患者胸部CT表现及治疗后演变探讨  

Discussion on chest CT findings and post-treatment evolution of novel coronavirus 2019 pneumonia(COVID-19)in critical ward

作　　者：罗艳[1] 詹亚琨[2] 李岩[1] 邢姗姗 徐昌民 马俊[1] 梁利民[1] 邹蓓 LUO Yan;ZHAN Yakun;LI Yan;无(the Second Affiliated Hospital of Nanchang University,Imaging Center,Jiangxi,330006,China;the Second Affiliated Hospital of Nanchang University,Emergency Department,Jiangxi,330006,China;the Second Affiliated Hospital of Nanchang University,Clinical Laboratory Nanchang,Jiangxi,330006,China)

机构地区：[1]南昌大学第二附属医院影像中心,南昌330006 [2]南昌大学第二附属医院急诊科,南昌330006 [3]南昌大学第二附属医院检验科,南昌330006

出　　处：《江西医药》2021年第1期13-17,共5页Jiangxi Medical Journal

摘　　要：目的探讨新型冠状病毒肺炎(COVID-19)重症病区患者胸部CT表现及治疗后演变特点。方法为全力支援武汉开展新型冠状病毒肺炎医疗救治工作,南昌大学第二附属医院援鄂国家医疗队137人于2020年2月15日整建制接管华中科技大学同济医学院附属协和医院肿瘤中心1个重症病区,从开始接管至2020年3月15日隔离病房关闭1个月内共接诊确诊84例重症新型冠状病毒肺炎患者,其中转出16例,出院68例,重型患者35例,其中危重型4例,轻症病人46例,现以在此1个月内完整治疗并出院68例患者为研究对象,回顾性分析重症病区患者胸部CT表现及治疗后演变特点。结果影像学表现采用胸部CT平扫检查,肺外带磨玻璃影(GGO)征象为主,并夹杂小叶间隔增厚、局灶片状实变、支气管扩张、纵膈淋巴结增大及纤维条索灶及出现胸腔积液多种CT征象。结论轻型重症患者,临床症状、核酸检测及CT进展同步发展,患者出院时CT征象基本吸收消失。重症及危重症患者的CT征象有滞后,临床症状消失,核酸检测多次阴性,血清抗体提示患者核酸抗体阳性,但CT征象提示病灶大小及范围仍较明显存在,且个别多于轻型重症患者,此时为防止复阳,暂缓出院,继续观察治疗,动态复查核酸、血清抗体及胸部CT,至病灶基本吸收或明显好转后安排出院。Objective To investigate the chest CT manifestations and post-treatment evolution of COVID-19(COVID-19)patients in critical disease areas.Methods In order to fully support the wuhan COVID-19 medical treatment work,the Second Affiliated Hospital of Nanchang university aid medical team of Hubei on February 15,137 people in 2020,the whole system to take over the XieHe hospital Affiliated to Tongji Medical College Huazhong University of Science and Technology Tumor center a severe ward,from start to take over to the isolation ward off on March 15,2020 a month altogether accepts confirmed 84 cases of patients with severe COVID-19,which turns out of 16 people,68 people,the discharge of heavy patients 35 people,including people with four critically ill,mild patients 46 people,A total of 68 patients who were treated completely and discharged from hospital within 1 month were selected as study subjects.The chest CT findings and post-treatment evolution characteristics of patients in critical ward were retrospectively analyzed.Results Plain chest CT scan was used for the imaging findings,and the main signs of GGO were interlobular septal thickening,focal patchy consolidation,bronchiectasis,mediastinal lymph node enlargement,fiber cords and pleural effusion.Conclusion The clinical symptoms,nucleic acid test and CT progress of patients with mild and severe diseases are synchronous,and the absorption of CT signs is basically disappeared when the patients are discharged from hospital.Severe and critical lag,the CT signs of patients with clinical symptoms disappeared,many negative nucleic acid detection,prompt nucleic acid antibody positive patients with serum antibody,but CT signs suggest lesion size and scope of still more obvious,and individual more than light in severe cases,at this time to prevent double Yang,a moratorium on discharge,to continue to observe the treatment,the dynamic review of nucleic acid,serum antibody and chest CT,to the basic absorption lesions or improved markedly after hospital discharge.

关 键 词：2019新型冠状病毒 2019新型冠状病毒肺炎 重症隔离病房 胸部CT 

分 类 号：R816.41[医药卫生—放射医学]