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目的 探讨SARS患者糖皮质激素治疗后胸部X线影像学变化。方法 回顾性分析我院 2 3例经糖皮质激素治疗的SARS患者胸部X线影像学资料 ,其中男 10例 ,女 13例 ,年龄 2 1～ 6 8岁。比较激素治疗前后肺部阴影的变化情况。结果 2 1例患者肺部阴影在 2 5～ 6 0天内完全吸收或明显好转 ,平均为 4 2 .8± 11.5天 ;2例患者肺部阴影逐渐扩大至两肺弥漫性渗出影死亡。激素治疗后肺部阴影变化可分为四种类型 :① 16例 (6 9.5 % )患者在应用激素后肺部阴影逐渐吸收 ;② 2例(8.7% )患者肺部阴影有所进展 ,3～ 4天后肺部阴影逐渐吸收 ;③ 3例 (13.1% )患者在应用激素 3～ 7天时肺部阴影较前无明显变化 ,之后肺部阴影逐渐吸收 ;④ 2例 (8.7% )患者病变范围未见明显吸收 ,反而逐渐增大 ,最后呈两肺弥漫性渗出影。结论 糖皮质激素治疗后胸部X线影像变化多样 ,对观察疗效和指导治疗有重要临床意义。
Objective To investigate the chest X-ray findings of patients with SARS treated with glucocorticoid. Methods A retrospective analysis of 23 cases of SARS patients treated with glucocorticoid in our hospital chest X-ray imaging data, including 10 males and 13 females, aged 21 to 68 years. Comparison of hormone changes before and after the shadow of the lungs. Results In 21 cases, the lung shadow completely absorbed or obviously improved within 25-60 days with an average of 42.2 ± 11.5 days. The lung shadow of 2 patients gradually enlarged to diffuse exudation of both lungs. There are four types of changes in the shadow of the lungs after hormone therapy: (1) 16 (65.5%) patients gradually absorb the shadow of the lungs after applying hormones; (2) 2 (8.7% 4 days after the gradual absorption of the lung shadow; ③ 3 patients (13.1%) in the application of hormones 3 to 7 days before the lung shadow no significant change, then the gradual absorption of the lung shadow; ④ 2 patients (8.7% See obvious absorption, but gradually increased, finally showed diffuse diffuse two lung shadow. Conclusion The changes of chest X-ray after glucocorticoid treatment are diverse and have important clinical significance for the observation of curative effect and guiding treatment.