论文部分内容阅读
目的 探讨老年尸体解剖中遇到的机化性肺炎的临床病理特点及其可能的原因。方法从1980-2003年635例老年人尸检资料中检出95例机化性肺炎,观察机化性肺炎的形态特点,并对其临床资料和影像学变化进行回顾分析。结果 机化性肺炎大多数病灶小、散在,经常出现在主要肺部疾病附近,不同病变相伴的机化性肺炎其病变特点也略有差别;95例机化性肺炎周围的主要肺部疾病有:(1)化脓性肺炎及肺脓肿以及慢性复发性肺炎(36例);(2)感染性疾病(真菌、病毒等17例);(3)吸人性肺炎(16例);(4)放射性肺炎(5例);资料还显示慢性胸膜炎、肺不张也常与机化性肺炎相伴。机化性肺炎肺部病变影像学表现呈多样性。结论 老年尸检中机化性肺炎是常见的伴发病变,与多种疾病相关,各种原因伴发的机化性肺炎形态学上大致相似。在相关因素分析中认为老年性机化性肺炎主要与细菌、真菌、病毒等感染有关;吸人性及放射性肺炎等也常伴发机化性肺炎。影像学上肺部感染患者长期不消散的阴影需考虑到出现机化性肺炎的可能。
Objective To investigate the clinicopathological features and possible causes of opportunistic pneumonia in elderly cadavers. Methods 95 cases of PCA were detected from autopsy data of 635 elderly people from 1980 to 2003. The morphological characteristics of PCA were observed. The clinical data and imaging changes were retrospectively analyzed. Results Most of the lesions in PCA were small and scattered. They were often found in the vicinity of major lung diseases. The pathological features of PCA were also slightly different. The main pulmonary diseases in 95 cases of PCA included : (1) suppurative pneumonia and pulmonary abscess and chronic recurrent pneumonia (36 cases); (2) infectious diseases (17 cases of fungi and viruses); (3) aspiration pneumonia (16 cases); Pneumonia (5 cases); the data also showed chronic pleurisy, atelectasis are often accompanied by organic pneumonia. Organic lung disease pulmonary lesions showed a diversity of imaging findings. Conclusions Machine-made pneumonia is a common concomitant pathological change in elderly autopsy, which is related to various diseases. The pathological findings of PCA are similar. In the analysis of relevant factors, it is considered that the main cause of PCA is associated with infections such as bacteria, fungi and viruses. Inhalation and radiation pneumonitis are often associated with opportunistic pneumonia. Long-term non-disappearance of the shadow of patients with pulmonary infection should take into account the possibility of organic pneumonia.