Quality the intersection of lung and fiber take clinical CT of disease diagnose the intersection of _ and symptom among the person who send specially

Quality the intersection of lung and fiber take clinical CT of disease diagnose the intersection of _ and symptom among the person who send specially
Specially the quality lung fiber disease clinical CT is diagnosed among the sending
Imprison, grow groups of the intersection of duckweed and Guo Chen It is flat
Lung fiber of the keyword; Diagnose, CTCategorised number R563 of the Chinese books and reference materials
Quality lung fiber take disease to be relatively common among the person who send specially, delay, diagnose, the intersection of quality and the intersection of fiber and the intersection of person who take and for irreversibility therapeutic effect correctly under lung of later period. For give play to CT assist, diagnose and treat early period while being clinical, to check by CT, it combines clinic and 20 reports that pathology verifies to be as follows author.
A materials and method1.1 13 men in 20 clinical materials, 7 women. 36-77 years old, 55.6 average years olds. 1 month of course of disease - 20 years. Clinic is phased ' 1, 2)Within one year is in early days, it is chronic one in more than 1 year. The number of this group is early 10, 10 of later period. Main clinical manifestation: The coughing, going on dyspnea, cyanosis, poke are pointed etc..1.2 Check positive 3 rheumatoid factors in the laboratory, acidophil increases by 3, IgG increases by 5, IgA increases by one, the leucocyte increases by 5. Qi and blood is determined: 10 are intermediate hypoxemia diseases, 7 are severe hypoxemia diseases, 3 because the condition is too heavy to do.1.3 The lung function is determined to keep in touch with 15 function obstacles restrictedly, keep in touch with 2 obstacles restrictedly for the master's mixing, 3 serious diseases have not been done.1.4 Make a definite diagnosis of, determine by clinic, the intersection of lung and function X-ray the intersection of chest and block, CT, laboratory check outside the materials according to 20, 7 examples are checked and made and punctured the lung by the bronchus wall at the same time and organize examining alive through the fibrous bronchus mirror, 2 check, do at the same time by the intersection of bronchus and mirror alveolus irritate lotion, check, corpse examine 2. Another 7 are diagnosed and accorded with: Irritation coughing, going on dyspnea, poke mean etc. behaving clinically; The vim and vigour is examined and determined as hypoxemia disease; Lung function determine, brief on restricted and person who mix keep in touch with obstacle; Typical chest X-ray and CT behave.1.5 Chest the intersection of X-ray and slice, CT check quality the intersection of lung and fiber take the intersection of X-ray and the intersection of chest and slice of disease, behave among the person who take place specially 10 early period: The lamination of lung is strengthened and taken the form of network, and is mixed with the tubercle or flaky shadow of spot, obvious in addition with the lung. CT behaves: See in the lung extensively tinily and nettedly, alveolately that accompanies the tubercle and high density shadow (Fig. 1) of spot slice ,Filling the air pulmonary emphysema, lung take the form of and rub the sand glassily to change, the neighbouring pleura of pathological change is increased thick. Another 10 X-ray chest slice of later period person behave: Accompany the tubercle shadow to be distributed in the lung extensively with the thick netted shadow, wild and obvious with the poor lung, the bright degree of increase of lung, the lung door shadow increases, right ventricle and atrium dextrum increase. CT behaves: The thick netted shadow accompanies the tubercle, spot or flaky shadow of string to be distributed in the lung, prominent with the periphery of poor lung (Fig. 2) ,Pulmonary emphysema of low density and great bubble of lung are distributed, the neighbouring pleura of pathological change is increased thick, the lung door and mediastinal enlargement of lymph nodes, the lung artery is increased under high pressure thickly, right ventricle, atrium dextrum increase.
2 is discussed2.1 The name of disease that specially a disease of pathology and clinic of the quality lung among the sending continues to use is various, still not unified. It is to take alveolus wall as the core and involve pathological change of the detailed bronchus field that its pathology changes, it is mainly inflammation of the alveolus wall, while with the fiber (1-6) . So the complying with of the lung takes place to reduce, the lung capacity is reduced and kept in touch with the obstacle restrictedly. Thin bronchitis is turned into and the small blood vessel of lung is stopped up, disharmony and disperse ability causing the lung to keep in touch with the proportion of blood flow are reduced, hypoxemia disease happens and breathe depletedly finally. The clinical characteristic of this disease: The case men of this group exceed women, mean age is similar to literature at 55.6 years old (1-6) . , cyanosis that the going on dyspnea, irritation cough, it is the important behaviour of this disease that the poke is meant etc..2.2 X-ray and CT of this disease display and contrast chest X-ray one and CT of 10 early patients and mainly display the characteristic such as foregoing with pathology. Examine the finding by the corpse, the hard tough sense of the lung texture, the elasticity is lowered, there are the bag outstanding bubbles not of uniform size on the surface of lung. It has ashen and flaky consolidation area of small spot that the tangent plane can be seen, alveolate bag bubbles, pieces of fiber Suo organize, fill the air, distribute, mostly lung edge district. The mirror makes the finding: The alveolus separates and increases thick, see that there are lymphocyte, plasma cell, monocyte, soak as fibrous cells; Companion of capillary hyperplasia tube wall increase thick, expand in the alveolus having the intersection of slurry and the intersection of albumen and material and upper leather cell,etc. that loss; Skin take grow, present square or reply layer while being false on the alveolus, form alveolate lung, change. The patient's chest X-ray one and CT mainly display the characteristic such as foregoing in 10 later periods. It is alive to organize and can see the interval of alveolus to increase to examine thick under the mirror by the lung, inflammation cell soak and alveolus wither, take the form of netted and the intersection of string and fiber of form Suo organize hyperplasia and alveolus take the form of bag fill the air, expand etc., change main fact into.2.3 Diagnosis and differential diagnosis such as clinical CT The author agrees the literature ' 1- 6)View, until unidentified irritation of reason cough and person who go on have difficulty in breathing etc., display on the clinic, combine X-ray chest one and CT to reveal one pair of lungs takes the form of netted or alveolate structure, and with tubercle or flaky shadow, pulmonary emphysema and large bubble of lung, the lung door shadow is increased to expand under high pressure by the lung artery, lymphadenovaris causes, right ventricle and atrium dextrum increase, should consider a disease. Following disease X-ray chest slice and CT are apt to misdiagnose as this disease. Chronic bronchitis: The lamination of lung is strengthened disorderlily, amalgamate filling the air pulmonary emphysema, is exactly like a disease at the time of the great bubbles of lung, only according to the X-ray chest slice, CT distinguishes the difficulty, needs to assist clinically; The lung is infected: Shut inflammation, infect by chronic bronchitis often, lamination strengthen and mix patch when the pulmonary emphysema and slice merge the shadow distribute by lung, X-ray chest slice and CT exactly like a disease behave, it is very difficult to distinguish only according to X-ray chest slice and CT, need to cooperate with clinic and lung histology to diagnose; Bronchiectasis: Chest stretch is shown as lamination of lung is taken the form of alveolately or nettedly, with the inflammatory shade of the slice sometimes in the X-ray. CT is shown as the person who takes the form of alveolate, tiny reticular formation of a pair of lung bronchiectasis, and pulmonary emphysema and great bubble of lung are distributed, it is apt to misdiagnose a disease that the above two kinds are checked, need to combine and help to distinguish clinically. As to to diagnose, check clearly disease this, CT to find, confirm sick position, cooperate with, carry on lung organize living ideal inspection method to examine pathological diagnosis while being clinical. The lung cross section picture of high resolution that CT reveals, amorphous overlap influences, choose most typical the intersection of pathological change and district, go on, puncture the dark department of distance that examines alive to enter the needle direction to operate from the intersection of chest and body surface to pathological change district accurately, it is apt to fetch to the reliable pathological change organization. Can prevent the intersection of X-ray and TV from perspect, lead, down, pierce through lung by leather chest living localization to examine position inaccurate, thus it is false and negative to appear, can't make a definite diagnosis of the purpose. For example, there are 2 examples that are similar to the situation in this text. 1 puncture lung, live, examine with another 1 perspecting leading, puncturing lunging, living, examining with the intersection of bronchus and mirror by the intersection of bronchus and wall by chest in TV, appear false and negative, because clinic and image it studies to be highly suspicious copies of disease, lead, puncture lung, live, examine by leather chest by CT, make accurate the intersection of pathological change and tissue of position, have obtained and made a definite diagnosis of the basis.
Author's unit: 110015 Shenyang General hospital of Military Area Command of Shenyang
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