摘要
2019年12月以来我国陆续出现新型冠状病毒(2019-nCoV)感染引起的以肺部病变为主的新型冠状病毒肺炎(简称新冠肺炎),主要临床表现为发热、干咳、气促、外周血白细胞不高或降低以及胸部CT改变等,严重者出现多脏器功能衰竭。随着对本病的认识不断加深,近期内已连续6次修订诊疗方案。新冠肺炎患者通常在发病前14天内有武汉或其他新冠肺炎传播地区的旅行史或居住史,或曾接触过来自疫区的发热或有呼吸道症状的患者,或为集聚发病。但随着疫情逐渐得到控制,临床以呼吸道症状前来就诊的患者的流行病学史已越来越模糊,各级综合医院陆续面对新冠肺炎诊断和鉴别诊断的挑战。现将新冠肺炎患者的临床表现及肺部影像学特征,与北京协和医院历年收治影像学表现为弥漫性肺病的其他肺部感染及非感染性疾病进行比较,尝试找出其相似及不同之处,为新冠肺炎鉴别提供线索,保证精准诊疗。
Novel coronavirus pneumonia was a novel coronavirus infection that has dominated pulmonary infection since December 2019.The main manifestations were fever,dry cough,shortness of breath,normal or leukopenia in peripheral blood and changes in chest CT and in severe cases,multiple organ failure might occur.The National Health Commission,PRC has revised the consensus on diagnosis and treatment seven times in a short period of time,indicating the growing understanding of the disease.Patients with novel coronavirus pneumonia usually had history of travelling or living in the epidemic area including Wuhan within 14 days before onset,or have been exposed to patients who had fever or respiratory symptoms from the epidemic area,or had clustering diseases.However,novel coronavirus pneumonia was becoming more and more blurred after vanishing epidemic.The diagnosis and differential diagnosis of novel coronavirus pneumonia were challenges not only because of large number of tourists increasing dramatically after the relieving of epidemic,but also patients with other diseases from different areas to search for medical care.In this article,the clinical and chest imaging features of the novel coronavirus pneumonia were reviewed and compared with other infections and non-infectious diffuse pulmonary diseases.We try to find the similarities and differences among them,and to identify clues to the diagnosis of novel coronavirus pneumonia,so as to ensure accurate diagnosis and treatment.
作者
田欣伦
彭敏
王汉萍
蔡柏蔷
许文兵
朱元珏
李太生
朱华栋
宋兰
王孟昭
张力
施举红
Tian Xinlun;Peng Min;Wang Hanping;Cai Baiqiang;Xu Wenbing;Zhu Yuanjue;Li Taisheng;Zhu Huadong;Song Lan;Wang Mengzhao;Zhang Li;Shi Juhong(Department of Pulmonary Medicine,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department Infection Disease,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Emergency,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Radiology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2020年第5期401-408,共8页
Chinese Journal of Tuberculosis and Respiratory Diseases
