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目的探讨甲型H1N1病毒所致肺炎的影像学特征。方法回顾性分析27例经实验室证实的甲型H1N1肺炎患者的胸部X线及CT影像学表现。结果按照甲型H1N1病毒肺炎的受累面积,将27例患者按初诊时肺部的影像改变程度分为轻、中、重度3种类型。轻度者10例,表现为散在分布的、斑片状磨玻璃样阴影;中度者9例,表现为双肺散在分布的、多发片状实变阴影及结节影,5例合并胸腔积液,并伴有轻、中度代偿性肺气肿;重度者8例,表现为双肺大片实变阴影伴有空洞,其中2例合并霉菌球,3例伴有支气管扩张,4例合并纵隔及胸壁皮下气肿,均伴有双侧胸腔积液及中、重度肺气肿。6例死亡病例中,1例为轻度肺炎恶化死亡,1例为中度肺炎转化为重度肺炎后死亡,其他4例为重度肺炎病例。结论甲型H1N1肺炎表现为多肺段受累的磨玻璃样变和实变,重度者常伴有空洞、支气管扩张、胸腔积液、纵隔皮下气肿及霉菌感染,死亡率高。
Objective To investigate the imaging features of pneumonia caused by influenza A (H1N1) virus. Methods A retrospective analysis of chest X-ray and CT findings in 27 cases of laboratory-confirmed type A H1N1 pneumonia was performed. Results According to the affected area of type A H1N1 virus pneumonia, 27 patients were divided into 3 groups: mild, moderate and severe. Mild in 10 cases, the performance of scattered, patchy ground glass-like shadows; moderate in 9 cases, the performance of the lungs scattered in the distribution of multiple disc-like consolidation of solid shadow and nodules, 5 cases of pleural effusion Liquid, accompanied by mild and moderate decompensated emphysema; severe in 8 cases, manifested as large double lung consolidation shadow associated with voids, including 2 cases of mold ball, 3 cases with bronchiectasis, 4 cases of merger Mediastinal and chest wall subcutaneous emphysema, are associated with bilateral pleural effusion and moderate to severe emphysema. Of the 6 deaths, 1 died of mild pneumonia, 1 died of severe pneumonia and 1 died of severe pneumonia. The other 4 cases were severe pneumonia. Conclusions Influenza A H1N1 pneumonia is a type of ground-glass-like change and solidification involving multiple lung segments. Severe patients are often associated with voids, bronchiectasis, pleural effusion, subcutaneous emphysema and fungal infection in the mediastinum, and high mortality.