外源性脂质性肺炎的临床特征分析  

Clinical characteristics of exogenous lipid pneumonia

作　　者：石飞[1,2] 叶伶 SHI Fei;YE Ling(Department of Internal Medicine,JiangYuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine,Wuxi 214063,Jiangsu,China;Department of Respiratory and Critical Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]江苏省原子医学研究所附属江原医院内科,无锡214063 [2]复旦大学附属中山医院呼吸与危重症医学科,上海200032

出　　处：《中国临床医学》2022年第5期823-825,共3页Chinese Journal of Clinical Medicine

摘　　要：目的探讨外源性脂质性肺炎(exogenous lipid pneumonia,ELP)的临床特征。方法回顾性分析2007年1月至2020年11月复旦大学附属中山医院13例ELP患者的发病诱因、临床表现、影像学改变、治疗及预后情况。结果8例(61.5%)ELP患者因肠梗阻口服石蜡油时误吸所致。ELP临床上主要表现为咳嗽(10例,76.9%)、发热(9例,69.2%)。84.6%(11/13)的患者C-反应蛋白升高,降钙素原升高的仅15.4%(2/13)。胸部CT显示,ELP好发于双下肺,常见改变为磨玻璃影(84.6%,11/13)、实变(69.2%,9/13)。从出现症状到被诊断的平均时间为60 d。治疗上除避免脂类物质误吸外,61.5%(8/13)的患者给予糖皮质激素治疗。结论ELP的临床表现、胸部CT改变不典型,易被误诊。避免脂类物质误吸是预防ELP的关键,早发现、早干预是治疗该病的关键。Objective To explore the clinical characteristics of exogenous lipid pneumonia(ELP).Methods The predisposing factors,clinical manifestations,imaging changes,treatment and prognosis of 13 patients with ELP in Zhongshan Hospital,Fudan University from January 2007 to November 2020 were analyzed retrospectively.Results Eight patients(61.5%)with ELP were caused by intestinal obstruction and inhalation of oral paraffin oil.The main clinical manifestations were cough(10 cases,76.9%)and fever(9 cases,69.2%).84.6%(11/13)patients had elevated C-reactive protein,while only 15.4%(2/13)patients had elevated procalcitonin.Chest CT showed that most of the lesions occurred in both lower lungs,and the common changes were ground glass shadow(84.6%,11/13)and consolidation(69.2%,9/13).The average time from symptom onset to diagnosis was 60 days.In addition to avoiding the aspiration of lipid substances,61.5%(8/13)patients were treated with glucocorticoid.Conclusion The clinical manifestations and chest CT changes of ELP are not typical and are easy to be misdiagnosed.Avoiding lipid aspiration is the key to prevent ELP,and early detection and early intervention is the key to treat the disease.

关 键 词：外源性脂质性肺炎 脂类物质 误吸 肠梗阻 误诊 

分 类 号：R563.1[医药卫生—呼吸系统]