摘要
目的:对比儿童细菌性肺炎坏死性肺炎(BPNP)与支原体肺炎坏死性肺炎(MPNP)的CT影像差异。方法:回顾性收集2015年1月-2020年10月于我院诊断为BPNP与MPNP患儿的病例资料,其中BPNP组63例,MPNP组30例。比较分析两组患儿的临床及CT影像学特征。结果:BPNP组患儿的平均年龄小于MPNP组,差异有统计学意义(P<0.05),而两组间性别差异无统计学意义(P>0.05)。两组的肺坏死表现及分布、实变区域、肺不张、支气管壁改变、肺间质改变、胸腔积液、液气胸及胸膜增厚差异具有统计学意义(P值均<0.05),而肺门淋巴结肿大情况差异无统计学意义(P>0.05)。BPNP组多采用胸腔闭式引流、胸膜纤维剥脱术及支气管胸膜瘘修补术,而MPNP组多采用纤维支气管镜治疗,两组差异有统计学意义(P值均<0.05),但两组间胸腔穿刺及肺叶切除术的发生情况差异无统计学意义(P值均>0.05)。结论:BPNP患儿的平均年龄小于MPNP,两者的临床治疗方式及CT影像表现有各自特点。BPNP多为单侧多叶实变伴坏死,坏死囊腔较大、多融合,常伴中大量胸腔积液或并发气胸,后遗改变多为条索影、胸膜增厚;MPNP则以单侧单叶实变伴坏死为主,坏死表现多以低密度影或小囊腔为主,常伴支气管壁改变及小气道病变,后遗改变多为条索影、支气管扩张或小气道病变。
Objective:To compare the CT findings of bacterial necrotizing pneumonia(BPNP)and mycoplasma pneumoniae necrotizing pneumonia(MPNP)in children.Methods:Clinical characteristics and CT findings of pediatric patients diagnosed with BPNP(n=63)and MPNP(n=30)in our hospital from January 2015 to October 2020 were retrospectively collected and analyzed.Results:The mean age of BPNP group was lower than that of MPNP group with statistically significant(P<0.05),while there was no statistical difference in gender between two groups(P>0.05).There were statistically significant differences in lung necrosis,consolidation,atelectasis,bronchial wall lesion,pulmonary interstitial lesion,pleural effusion,pneumothorax and pleural thickening between groups(all P<0.05),while there was no statistical difference in hilar lymphnode enlargement between two groups(P>0.05).The BPNP group was mostly treated with pleural fiber stripping and bronchopleural fistula repair with closed drainage,while the MPNP group was mostly treated with bronchoscopy.The differences between the two groups were statistically significant(all P<0.05),but there was no significant difference in pleural puncture or lobectomy between the two groups(both P>0.05).Conclusion:The mean age of BPNP is lower than that of MPNP,and the clinical treatment and CT findings of BPNP and MPNP have their own characteristics.BPNP is mostly one-sided muti-lobe consolidation and necrosis,with large and fused necrotic cystic cavity,accompanied by a large amount of pleural effusion or pneumothorax,and most of the residual changes are strip shadow and pleural thickening.MPNP is dominated by single lobe consolidation and necrosis,with lower density or small cystic cavity as the main manifestation of necrosis,accompanied by bronchial wall changes and small airway lesions,and most of the residual changes are bronchiectasis,small airway lesions and fiber strip shadow.
作者
郑英兰
陈欣
王浩入
张黎
丁浩
何玲
ZHENG Ying-lan;CHEN Xin;Wang Hao-ru(Department of Radiology,Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)
出处
《放射学实践》
CSCD
北大核心
2022年第5期611-615,共5页
Radiologic Practice
基金
重庆市科卫联合医学科研项目(2020FYYX128)
重庆市渝中区基础研究与前沿探索项目(20200155)
重庆市技术预见与制度创新项目(cstc2021jsyj-yzysbAX0019)。
