摘要
目的探讨医院获得性肺炎与呼吸机相关性肺炎(HAP/VAP)的CT征象。方法回顾性分析获得临床及病原学确诊的多重耐药细菌性HAP/VAP 59例,所有病例均行CT平扫+多平面重组。将所有患者分为单纯感染组和混合感染组,然后根据分组将CT征象按照有和无两种状态分别记录患者例数,并建立四格表,采用卡方检验,P<0.05被认为差异有统计学意义。结果单一多重耐药细菌感染33例,多种多重耐药细菌混合感染26例。单纯感染组和混合感染组在有无小叶间隔增厚(P=0.008)、累及肺叶数量(P=0.031)、多个CT征象并存情况(P=0.038)等方面有统计学差异;而在有无磨玻璃样病变、实变类型、有无支气管壁增厚、有无胸腔积液等方面无明显统计学差异。结论耐药细菌性HAP/VAP的CT征象有一定的特征,且单一耐药细菌感染与多种耐药细菌混合性感染的CT征象具有一定的区别,对经验性抗菌药物的使用具有参考价值。
Objective To investigate the CT features of hospital-acquired pneumonia/Ventilator-associated pneumonia(HAP/VAP).Methods A retrospective analysis of 59 cases of multi-drug resistant bacterial HAP/VAP with clinical and etiology diagnosis was performed between 2015 and 2017.All cases had underwent CT scan and multiplanar reconstruction.All patients were divided into simple infection group and mixed infection group,then the CT features were recorded according to the group,according to the presence and absence of the two modes,and a four-square table was established.The chi-square test was used,and P<0.05 was considered statistical.Results There were 39 males and 20 females’aged 23-86 years,with a median age of 66 years.There were 33 cases of single multi-drug resistant bacteria infection and 26 cases of multiple multi-drug resistant bacteria.There were statistical differences between the simple infection group and the mixed infection group in the presence or absence of conditions,including lobular septal thickening(P=0.008),number of lobes involvement(P=0.031),and status of multiple coexisting CT signs(P=0.038).There were no statistically significant differences in Ground-Glass Opacity(GGO),range of consolidation,presence or absence of bronchial wall thickening,and presence or absence of pleural effusion.Conclusion There were certain characteristics on the CT manifestations of drug-resistant bacterial HAP/VAP,and there were some differences between the single-drug resistant bacterial infection and mixed infection of multiple drug-resistant bacteria in the CT signs.Understanding the characteristics of CT may be helpful for empirical antimicrobial agents.
作者
张禹
陈婷婷
张茜
朱友志
ZHANG Yu;CHEN Tingting;ZHANG Qian(Department of Medical Imaging,The 901st Hospital of the Joint Logistics Support Force of PLA,Hefei,Anhui Province 230031,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第10期1967-1970,共4页
Journal of Clinical Radiology
关键词
医院获得性肺炎
呼吸机相关性肺炎
体层摄影术
X线计算机
Hospital acquired pneumonia
Ventilator-associated pneumonia
Infection
Tomography,X-ray computed
