渔民急性中重度硫化氢中毒的肺部CT表现

摘要

Objective To discuss the clinical manifestations and CT features of acute moderate or severe hydrogen sulphide poisoning fishermen.Methods The clinic and CT datas of 8 acute moderate or severe hydrogen sulphide poisoning cases were retrospectively analysed.Results The lesions located at two pulmonary each leaf in 3 cases,located at both lower lungs in 3 cases and asymmetry leaves in 2 cases.Lesions form:little patchy shadow in 8 cases (8/8),fibrous band shadow in 4 cases (4/8),ground glass shadow in 3 cases (3/8),peripheral fuzzy interlobular nodule in 4 cases (4/8); 5 cases complicated with pleural effusion;After treatment 6～10 days,the pulmonary shadows were absorbed obviously; Fibrous band shadow was residual in a case after a follow-up of 2 months.Conclusion With definite history of hydrogen sulphide inhalation and the corresponding clinical manifestations,and if fishermen contacted for a long time,who would be made chemical pulmonary damage; Combined with the imaging manifestations,the diagnosis as well as the severity of pulmonary damage could be made.%目的 探讨渔民急性中重度硫化氢中毒的胸部CT影像学表现.方法 回顾分析急性中重度硫化氢中毒的肺部CT影像学表现,为进行合理的治疗提供依据.结果 8例患者首次CT表现为两肺对称性各叶均有多发斑片状渗出阴影6例,两肺下叶对称性受累3例,不对称性累及2例.病灶形态:斑片状影8例.条索状影4例,磨玻璃状影3例,周边模糊的小叶性结节影4例;5例合并胸腔积液.治疗后6～10d肺部阴影吸收明显.2例患者治疗2个月后进行随访,1例肺部病灶完全吸收,1例仍有残留纤维条索状影.结论 临床上有明确的硫化氢吸入史及相应的临床表现,且接触时间较长,可发生化学性肺损伤,结合胸部CT表现可作出急性硫化氢中毒的诊断并对肺脏损害的严重程度作出评估.