摘要
目的探讨新型冠状病毒肺炎(COVID-19)患者康复期胸部影像学特点。方法分析武汉市武昌区水果湖社区2020-01-02-2020-05-06277例确诊COVID-19患者出院1个月后血常规和高分辨率肺部CT(HRCT)等临床及影像学资料,动态分析胸部CT病变分布及形态表现,比较非重症者和重症患者影像学特征表现差异。结果277例确诊COVID-19患者轻型131例(47.3%),普通型102例(36.8%),重型42例(15.2%),危重型2例(0.7%)。HRCT扫描显示,60例(21.7%)患者肺部影像学表现正常,217例(78.3%)遗留肺部病变;165例(59.5%)残留病灶侵犯双肺,52例(18.8%)侵犯单肺,重型/危重型患者肺部CT残留病变累及双肺比例(79.5%)较轻型/普通型(55.8%)高,差异有统计学意义,χ2=8.669,P=0.003。轻型/普通型与重型/危重型患者肺部CT表现均遗留多发淡薄片或斑片状磨玻璃密度影、肺纤维条索状影、纤维化病灶及残存肺多发感染性病变,组间差异无统计学意义,χ2=3.268,P=0.071。结论COVID-19康复期患者肺部影像学表现为大多数患者仍残存肺多发斑片状感染性病变、肺磨玻璃样密度病灶、不规则纤维索条影、纤维化改变及肺部结节等特征性病变,重型/危重型患者肺部CT残留病变累及双肺比例较轻型/普通型高,社区随访HRCT能追踪残存病灶的动态改变,为降低肺残存病变发展为肺纤维化提供依据。
Objective To investigate the pulmonary imaging features of novel coronavirus 2019(COVID-19)in convalescence stage.Methods Analyzed the clinical and imaging data of 277 confirmed COVID-19 patients 1 month after discharge from the hospital in Shuiguohu Community,Wuchang District,Wuhan City.The distribution and morphological manifestations of chest CT lesions were analyzed dynamically,and the differences in imaging characteristics between nonsevere patients and severe patients were compared.Results 277 confirmed COVID-19 patients were 131(47.3%)cases of mild type,102(36.8%)cases of common type,42(15.2%)cases of severe type,and 2(0.7%)cases of critical type.HRCT scan showed:60(21.7%)patients had normal lung imaging findings,217(78.3%)had residual lung lesions.165(59.5%)had residual lesions invading both lungs,and 52(18.8%)had invaded one lung.The proportion of lung CT residual lesions involving both lungs in severe/critically ill patients(79.5%)was higher than that of mild/common type(55.8%),the difference was statistically significant,χ2=8.669,P=0.003.The lung CT findings of mild/normal and severe/critically ill patients all left multiple light thin slices or patchy ground glass density shadows,pulmonary fibrous cord shadows,fibrotic lesions and residual lung multiple infectious lesions.There was no difference between the groups statistically significant,χ2=3.268,P=0.071.Conclusions Pulmonary imaging findings of patients with COVID-19 during the recovery period show that most patients still have multiple patchy infectious lesions of the lung,lung ground-glass density lesions,irregular fiber cords,fibrotic changes,and pulmonary nodules.For severe/critically ill patients,the proportion of lung CT residual lesions involving both lungs is higher than that of mild/common type.Community follow-up HRCT can track the dynamic changes of residual lesions and provide a basis for reducing the development of residual lung lesions into pulmonary fibrosis.
作者
林杰
张玲
王忠莉
LIN Jie;ZHANG Ling;WANG Zhong-li(Department of General Practice,Shuiguohu Street Community Health Service Center,Wuchang District,Wuhan City,Wuhan 430071,China)
出处
《社区医学杂志》
CAS
2021年第10期631-634,共4页
Journal Of Community Medicine
基金
国家中医药管理局“社区防控突发重大传染性疾病中医药信息平台构建研究”(2020ZYLCYJ04-6)
关键词
新型冠状病毒肺炎
康复期
胸部影像学特征
novel coronavirus disease 2019
rehabilitation period
chest imaging features
