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1.
目的:探讨重症急性呼吸道综合征(SARS)的影像及临床表现和特征.方法:回顾性分析17例经临床证实及/或实验室检测证实的SARS的影像动态变化和临床表现.结果:影像表现:多在发热3d内出现肺部阴影(10例),以片状为主(16例),可为单侧(9例),也可为双侧(8例),两肺中下野多发,常为多叶段同时发病.病变多在发病1~7d明显进展加重,此起彼伏;多在两周内开始吸收.临床均以发热为首发症状(17例),体温>38.℃,以咳嗽(15例)、咳痰(12例)、乏力(10例)和肺部音(11例)为主要症状体征.白细胞正常或降低,淋巴细胞减少或偏低.抗生素治疗不敏感.结论:影像学检查是诊断该病和观察病情变化的最重要指标之一.结合临床和实验室检查尤其流行病学史便可明确诊断.  相似文献   

2.
目的 :探讨急性呼吸系统综合征的胸部影像学表现及临床特点。方法 :对经确诊的 30例严重急性呼吸综合征患者的胸部影像学表现和临床特点进行回顾性分析。结果 :此 30例SARS患者的胸部影像学表现由肺实质的渗出或 /和间质的渗出程度所决定 ,根据病变早期及进展期的表现分为 4型 :(1 )局限小片型 :8例 ,早期为一片状局限灶性实变 ,随后病灶可增大 ,然后渐次吸收。(2 )广泛大片型 :6例 ,由早期单一局限片状病灶迅速发展为广泛大片状影(范围≥ 2个肺野 )。(3)间质肺纹型 :1 0例 ,主要表现为肺间质渗出性炎症 ,可有“粗网”、“细网”、“网点”之分。(4)多发混合型 :6例 ,早期即见肺内多发(病灶数目≥ 2个 )片状及结节状病灶或 /和与其它肺野的“网格状”及“网 -点状”阴影共在。结论 :X线检查是发现SARS的最基本的影像学检查方法。CT能更好地显示病变。在SARS的诊治过程中 ,影像学的“三有”与“三无”和实验室检查的“三高”与“三低”对诊断分型、分期有益 ,并有助于判断病情 ,指导治疗 ,估计预后  相似文献   

3.
目的:探讨数字化X线摄影(digital radiogtrphy,DR)中双能量减影(dual energy subtraction,DES)技术在胸部疾病,特别是外伤性肋骨骨折、少量气胸及结节性病变中的诊断价值。方法:收集2006.10~2007.8月于我院就诊的120例胸部外伤或肺部疾病患者,进行DR双能量减影胸部后前位X线检查,分别获得标准影像、软组织影像和骨骼影像;本组病例分别由两组(每组2人)经验丰富的主治医师和副主任医师分别阅片、分析、诊断,对影像质量进行评价,并形成一致诊断意见。结果:本组120例患者共摄取DES片360幅,均能满足临床诊断。其中胸部外伤102例,肺炎8例,肺结核5例,肺癌合并阻塞性炎症2例,矽肺2例,结节病1例。DR标准片图像质量优良,可显示骨性胸廓结构和肺纹理;DES骨骼影像在显示心影、腋中线、膈下腹部脏器结构重叠的肋骨方面优于标准影像;软组织影像在显示肺内小结节病灶优于标准影像。结论:胸部DR双能量减影可清晰显示肋骨骨折,少量气胸和肺内病变,特别是对隐蔽处轻微骨折,少量气胸和肺内细小病变的诊断有较高应用价值。  相似文献   

4.
老年肺炎96例临床分析   总被引:1,自引:0,他引:1  
目的:探讨老年肺炎的临床特点,减少临床误诊率,提高老年肺炎的诊疗水平.方法:对2008年1月~2010年1月住德州市人民医院资料完整的96例65岁以上肺炎病例进行回顾性分析.结果:既往有慢性心,肺疾病,脑血管病,糖尿病等基础病及高龄者发病多,发病以冬春季节为多.临床症状:约2/3患者有发热、咳嗽、咳痰等呼吸道症状,1/3的患者以非呼吸道症状为首发症状.47%有心力衰竭、呼吸衰竭、电解质紊乱等并发症.痰培养显示革兰氏阴性杆菌多,双肺CT及X线检查以双肺小片状渗出影多见.结论:正确认识老年肺炎的临床特点,做出早期诊断和治疗,提高治愈率,降低死亡率.  相似文献   

5.
1、流行病学史 :①发病前 2周曾密切接触过同类病人或者有明确的传染给他人的证据 ;②生活在流行区或发病前 2周到过非典型肺炎正在流行的地区。2、症状与体征 :有发热 (>38℃ )和下列一项或一项以上 :咳嗽、呼吸加速、气促、呼吸窘迫综合征、肺部罗音、肺实变体征。3、实验室检查 :早期血白细胞计数不升高 ,或降低。4、肺部影像学检查 :肺部不同程度的片状、斑片状浸润性阴影或呈网状样改变。5、抗菌药物治疗无明显效果非典型肺炎病例常见特征@吴琼  相似文献   

6.
一、有关非典的测试题1.据研究认为,SARS的病原体可能是()A.衣原体B.类病毒C.冠状病毒D.细菌2.SARS主要破坏人体的()A.免疫系统B.血液循环系统C.呼吸系统D.消化系统和神经系统3.下列不属于SARS传播途径的是()A.飞沫传播B.空气传播C.近距离接触D.血液传播及食物传播4.SARS与HIV的共性是()A.传播途径相同B.发病症状相似C.潜伏期一样D.无完整的细胞结构5.SARS侵袭人体肺部,能使肺失去弹性,从而导致肺硬变。据你推测,肺硬变的主要病变是()A.分泌物中含有大量液体B.组织细胞脱落C.大量肺泡细胞增殖D.组织纤维化6.新的冠状病毒…  相似文献   

7.
目的:观察住院精神病患者口服氯氮平后引起吸入性肺炎的X线影像。方法:对2010年至2011年住院精神病患者口服氯氮平后引起吸入性肺炎56例患者的胸部X线影像进行分析。结果:病灶影像为肺内单发或多发斑片状模糊影,而流涎是氯氮平治疗早期最常见的一种不良反应,大约64.3%的患者出现流涎。结论:应密切观察服用氯氮平患者的病情变化,必要时进行胸部X线检查。  相似文献   

8.
目的 :为探讨基层医院在病原诊断条件有限情况下 ,如何临床诊治肺炎支原体肺炎。方法 :我们自 96年 3月~ 99年 3月对住院肺炎患儿 178例 ,结合病史、体检和实验室检查 ,X线胸正位片 ,门诊给予青霉素族抗生素治疗效果欠佳者 ;参照有关资料临床诊断为肺炎支原体肺炎87例。给予乳精酸红霉素加双黄连粉针剂治疗。结果 :治疗 2~ 3天体温降至正常 ,一周后85 1%患儿症状与体征消失 ,三周后随访 6 3例 ,并摄胸正位片对照 ,5 8例炎症完全吸收 ,痊愈率92 1%。结论 :本文资料说明在不具备病原诊断条件时 ,完全可以结合病史 ,临床症状及体征 ,血常规和一般胸部摄片予以诊断。早期给予大环内酯类抗生素—红霉素治疗 ,疗程二周 ,并配以双黄连粉针剂 ,可提高临床治愈率  相似文献   

9.
胸部X线检查对于诊断宝宝的肺部疾病很有帮助。临床的检查方法有两种,即胸部X线摄片(简称胸片)和胸部X线透视(简称胸透)。  相似文献   

10.
目的:总结新生儿呼吸困难胸片X线征象及原因,提高新生儿呼吸困难X线诊断率。方法:本文对92例新生儿呼吸困难胸片回顾性分析,结果:92例新生儿呼吸困难胸部平片X线诊断,1.新生儿肺炎44例,占47.8%;2.新生儿透明膜病15例,占16.3%;3.新生儿湿肺病12例,占13%;4.新生儿气胸,14例,占15.2%;5.双肺透亮度减低4倒,占4-3%;6.正常9例,占9.78%;7.心脏改变(先心)5例,占5.4%。结论:导致新生儿呼吸困难的最常见的肺部病变有:新生儿肺炎、新生儿透明膜病、新生儿湿肺、新生儿双肺充气不良、新生儿气胸以及循环异常类(先天性心脏病)。  相似文献   

11.
目的探讨普通型2019冠状病毒病(COVID-19)患者的临床表现与高分辨率CT(HRCT)的影像特征。方法回顾性分析我院收治的25例COVID-19确诊患者的临床资料及胸部CT检查,进一步分析其临床特征、实验室指标及HRCT影像学特征。结果我院收治的25例COVID-19患者均为普通型,发热(19/25,76%),干咳(18/25,72%);所有患者白细胞计数均正常,淋巴细胞计数不同程度减少(15/25,60%),血沉增快(12/25,48%),C反应蛋白升高(10/25,40%),出现降钙素原降低(2/25,8%);平均住院日为19.8±3.9天,从出现临床症状到CT检查阳性平均时间为4.9±2.7天。首次胸部HRCT病灶分布为单侧9例(36%,左肺4/25,16%;右肺5/25,20%),双侧16例(64%);20例(80%)病灶分布位于周边,5例(20%)位于周边为主及中心同时受累。HRCT表现中单纯磨玻璃影(GGO)为25例(100%),GGO伴局灶性实变为5例(20%),4例(16%)伴片状实变影。在第二次HRCT检查中,大部分患者病灶增多、范围变广,局部病灶融合,并见支气管充气征。结论普通型COVID-19患者临床表现相对较轻,HRCT是其诊断和评估的重要手段。  相似文献   

12.
目的:探讨Tornwaldt囊肿的低场MRI表现特征与临床特点。方法:回顾性分析5840例颅脑低场MRI资料,重点分析Tornwaldt囊肿MRI表现特点、出现率、临床表现。结果:5840例中发现108例Tornwaldt囊肿,出现率为1.85%。病变位于鼻咽后壁正中粘膜下,均呈圆形或椭圆形,直径或长径:2mm~23mm,平均9mm。病灶呈T1W低T2WI高信号(类似脑脊液信号)75例,呈T1WI及T2WI高信号33例。82例无明显相关症状,26例有咽部和(或)颈前不适症状。结论:Tornwaldt具有特征性的发病部位及MRI信号特点。  相似文献   

13.
目的:探讨大实有羸状这种真实假虚的征候在临症时如何进行识剐,才不致为假想所蒙蔽,无犯实实虚虚之戒。方法:从两例具体病例的治疗进行分析。结果:两例病例通过仔细分析,排除了假虚之象,抓住了真实之本,治疗效果理想。结论:大实有羸状这种证候,在临症时,欲别具慧眼,只有四诊合参,全面分析,由此及彼,由表及里,去伪存真,才能抓住疾病的本质,不致为假想所蒙蔽。  相似文献   

14.
Objective: To investigate changes in magnetic resonance spectroscopy (MRS) of lentiform nucleus during the early stage of Parkinson's disease. Methods: Twenty-five patients with idiopathic Parkinson disease with unilateral symptoms (IPDUS) and 25 healthy volunteers were enrolled in this study. MRS of the lentiform nucleus in each patient was taken and then concentrations of N-acetylaspartate (NAA), Creatine (Cr) and Choline (Cho) were calculated. Results: Compared to that in the control, NAA/(Cho Cr) was significantly lower in the lentiform nucleus contralateral to symptoms and even that in the ipsilateral side in IPDUS patients (all P<0.05); while there was no difference between the two sides in the healthy volunteer (P>0.05). The ratio of NAA/(Cho Cr) ipsilateral to the sympatomatic side of the patient was also lower than that of the control (P<0.05). Conclusions: there might be some changes with MRS on the lentiform nucleus during the early stage of idiopathic Parkinson's disease with unilateral symptom. MRS may be one of the reliable methods for early or even sub-clinical diagnosis.  相似文献   

15.
目的 :为临床诊断及排除严重急性呼吸综合征 (SARS)提供依据和对留观及密切接触医护人员有无感染作初步调查。方法 :用酶联免疫吸附测定 (ELISA) 5 3例临床诊断病例、2 9例疑似病例、6 3例留观及 114例密切接触医护人员的血清中SARS冠状病毒IgG、IgM抗体。结果 :SARS临床诊断病例IgG抗体阳性 2 1例 ,IgM抗体阳性 18例 ,其中有 17例IgG、IgM抗体均为阳性 ,总阳性率为 4 1.5 % ;留观人员IgG抗体阳性 1例 ;其他均为阴性。 结论 :ELISA测定血清抗SARS冠状病毒抗体阳性病例可确诊感染病毒 ,对于观察期后 (一般为 2 1d)人员 ,阴性结果可以排除感染。  相似文献   

16.
Celiac disease (CD) is a type of intestinal malabsorption syndrome, in which the patients are intolerant to the gliadin in dietary gluten, resulting in chronic diarrhea and secondary malnutrition. The disease is common in Europe and the United States, but only sporadic reports are found in East Asia including China. Is CD really rare in China? We examined 62 patients by capsule endoscopy for chronic diarrhea from June 2003 to March 2008. Four patients with chronic diarrhea and weight loss were diagnosed to have CD. Under the capsule endoscopy, we observed that the villi of the proximal small bowel became short, and that the mucous membrane became atrophied in these four patients. Duodenal biopsies were performed during gastroscopy and the pathological changes of mucosa were confirmed to be Marsh 3 stage of CD. A gluten free diet significantly improved the conditions of the four patients. We suspect that in China, especially in the northern area where wheat is the main food, CD might not be uncommon, and its under-diagnosis could be caused by its clinical manifestations that could be easily covered by the symptoms from other clinical situations, particularly when it came to subclinical patients without obvious symptom or to patients with extraintestinal symptoms as the initial manifestations.  相似文献   

17.
OBJECTIVE: This study compares abnormal genital examination findings made by pediatric emergency medicine (PEM) physicians to examinations by physicians with training in child sexual abuse in the evaluation of prepubertal girls for suspected sexual abuse. METHOD: A prospective study was performed following the genital examination by a PEM physician of prepubertal girls suspected of being sexually abused. A physician with training in child sexual abuse re-examined those girls whose examinations were interpreted as abnormal by the PEM physicians. The findings and interpretations of the PEM physician were then compared to those by the physicians with training in child abuse. RESULTS: Between October 1994 and October 1998, 46 patients diagnosed by PEM physicians with nonacute genital findings indicative of sexual abuse were re-examined by a physician with training in child abuse. The follow-up examinations were done 2 days-16 weeks (mean 2.1 weeks) after the emergency department visit. The physicians with training in child abuse concluded that only eight of these children (17%) showed clear evidence of abuse. Normal findings were noted in 32 children (70%), nonspecific changes were noted in 4 children (9%), and 2 children (4%) had findings that are more commonly seen in abused children than nonabused children but are not diagnostic for abuse (concerning for abuse). CONCLUSIONS: There was poor agreement between the pediatric emergency medicine physicians and the physicians with training in child sexual abuse. This study suggests that emergency medicine physicians should consider additional training in this area. In addition, all children with abnormal ED examinations should have follow-up examinations by a child abuse trained physician.  相似文献   

18.
目的:了解SARS的流行病学特征.方法:采用面对面与可视电话相结合的方式,填写统一的流行病学调查表.结果:19例SARS患者职业以学生、流动人员为主;年龄20~40岁为发病高峰;始发病例为输入型病例;传播范围日趋缩小.结论:我院SARS患者的流行病学特征与其它省市报道基本一致.  相似文献   

19.

Objectives

Parental depression symptoms often change over the course of child welfare family preservation and parenting services. This raises the question of whether certain processes in family preservation services might be associated with depression symptom change. This study tests three correlational models of change among family preservation service participants: (a) changes in depression symptoms are one facet of broad general changes in wellbeing; (b) the quality of the home visitor-client relationship is associated depression symptom changes; and (c) linking parents to adjunctive services is associated with symptom changes.

Methods

Participants were 2,175 parents in family preservation services, largely for child neglect, who were surveyed using standard measures at pre-treatment, post-treatment and 6 month follow-up. Change patterns were evaluated using growth models, including bivariate parallel and multivariate second-order models.

Results

Parallel growth was noted among depression symptoms and changes in social, economic, familial, and parenting domains. A second order change model positing a global change pattern fit the data well. Working alliance had a modest association with improvement, but successful linkage to outside mental health services was not associated with improvement.

Conclusions

Changes in diverse indicators of wellbeing follow a global pattern which might support use of less complex rather than more fully comprehensive service plans. Findings about lack of adjunctive usual care mental health service benefit may be related to uncontrolled factors and this is a topic in need of additional study.  相似文献   

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