摘要
目的:探讨小儿严重急性呼吸道综合征(SARS)临床影像表现及其动态变化,比较其与成人SARS的共同点和不同点。方法:搜集我院2003年2～4月住院确诊病例36例的临床影像资料。患儿临床特征为发病急骤,以发热、咳嗽为主要症状,肺部体征少。所有病例在疾病的早期、高峰期、恢复期、临床痊愈期等各期最少各有1次胸部正位X线照片检查。结果:①根据病灶形态、大小、分布以及肺纹理的改变特点分为3种类型:实变型25例,以大片状和节段性浸润为主;间质浸润型8例,病灶以肺纹理增粗增多、紊乱为主,伴有网点状或点状阴影;混合型3例,肺纹理改变明显,伴有斑片状实变影。②动态变化:大部分病例在1～3d内可见明确病灶;高峰期一般在4～7d;病灶基本吸收或完全吸收时间一般在15～30d,仅1例超过30d。结论:小儿SARS病灶出现早、发展快,吸收相对较慢,但比成人快;肺部病灶以大片实变为主,单侧受累为主。胸片X线照片是协助小儿SARS诊断的主要手段之一。
Objective To explore the clinical imaging findings and the dynamic changes of pulmonary lesions of severe acute respiratory syndrome(SARS) in children, and to compare with SARS in adults. Methods The clinical data and X-ray findings were collected from 35 cases of SARS admitted from Feb, 2003 to Apr, 2003, including 19 boys and 17 girls. Their ages were 3 months to 13 years with the average of 8.9 years. All the cases were attacked rapidly and mainly with the symptoms of fever and cough and few signs in the lungs. They were radiographed on chest at least one time at the initial stage, the progressive stage, the fastigium and the absorbing stage. Results ①According to the form, size and distribution of the pulmonary lesions and the changes of lesion markings, the imaging findings of SARS were categorized to three types: A. the type of massive consolidation (25 cases): the patchy and segmental lesions were dominated; B. the type of pulmonary interstitial infiltration (8 cases): the lung markings became coarse, increasing and disarranged with reticular and dotty shadows; C. the mixed pattern (3 cases): the changes of the lung markings were obvious with the shadow of patchy consolidation. ②The dynamic changes were presented as that the lesions were found within the first 1～3 d in most patients, the peak occurred on the 4～7 d, and the lesions were absorbed mainly or completely during the 15～30 d, except one case whose course was over 30 days . Conclusions The pulmonary lesions of SARS appear early and progress promptly. The absorption of the lesions in children is fairly slow, but still faster than that in adults. The lesions manifest as the massive consolidation especially in the unilateral lung. Chest radiography is a useful tool for the diagnosis of SARS in children.
出处
《诊断学理论与实践》
2004年第3期192-195,共4页
Journal of Diagnostics Concepts & Practice
