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目的:探讨高分辨率CT在判断慢性阻塞性肺疾病合并肺间质纤维化程度及预后中价值。方法:选取2014年5月至2015年1月郁南县人民医院诊治的慢性阻塞性肺疾病合并肺间质纤维化患者40例,并对其肺间质纤维化的CT和高分辨率CT表现进行回顾性分析。结果:(1)40例肺气肿合并肺间质纤维化患者中,重度肺气肿患者55.0%,中度肺气肿患者45.0%;(2)本研究患者均属于全小叶型肺气肿,其中8例患者合并2个肺小叶中心型肺气肿,4例合并有间隔旁型肺气肿,6例合并肺大泡;(3)本研究患者CT和高分辨率CT表现以小叶间隔增厚、小叶内间质增厚和支气管血管束变细为主,病灶主要分布于两肺中下野外带、下野外带;(4)治疗1年后,16例肺气肿征象变化不明显,支气管血管管束变形、扭曲加重,6例蜂窝范围增大,15例小叶间质隔明显增厚,3例小叶内间质进一步增厚。结论:高分辨率CT在以肺气肿为主的慢性阻塞性肺疾病合并肺间质纤维化临床诊断中有重大临床价值。
Objective: To explore the value of high resolution CT in judging the degree and prognosis of pulmonary interstitial fibrosis in patients with chronic obstructive pulmonary disease. Methods: Forty patients with chronic obstructive pulmonary disease and pulmonary interstitial fibrosis diagnosed and treated in Yunan People’s Hospital from May 2014 to January 2015 were selected. CT and high resolution CT findings of pulmonary fibrosis Retrospective analysis. Results: (1) 55.0% of patients with severe emphysema and 45.0% of patients with moderate emphysema were found in 40 patients with pulmonary emphysema and pulmonary fibrosis. (2) All of the patients in this study belong to total lobular emphysema , Of which 8 were combined with two pulmonary heart disease emphysema, 4 with emphysema and 6 with bullae; (3) CT and high resolution CT findings in this study were based on the interlobular septum Thickening, interstitial thickening of the leaflets and bronchovascular bundles. The lesions were mainly located in the outer and middle field of the two lungs, and were taken out of the field. (4) After 1 year of treatment, the signs of emphysema in 16 patients did not change significantly , The bundle of bronchovascular bundles was distorted and aggravated. The size of the beehive increased in six cases, the septum thickening was obvious in 15 cases, and the thickening of interstitial in 3 cases. Conclusion: High-resolution CT has great clinical value in the clinical diagnosis of chronic obstructive pulmonary disease with pulmonary emphysema and pulmonary fibrosis.