急诊发热伴胸部病变患者的CT诊断及鉴别诊断

目的通过分析急诊发热伴胸部病变患者的的临床特点及胸部CT表现类型,以总结诊断经验来提高对此类患者的诊断水平。方法回顾性分析109例因急诊发热、症状重、胸部CT示肺部明显异常、常规抗感染治疗效果不佳而收治入院患者的临床及影像资料。结果急诊发热伴胸部病变患者老年人多,伴有慢性基础疾病的多,重症肺炎患者比率大,预后较差;发热原因以感染性疾病为主,其胸部CT异常以磨玻璃及实变、胸水等肺部感染征象为主;非感染性疾病胸部CT以胸腔积液较常见。结论急诊发热伴胸部病变患者的临床及影像表现复杂,胸部CT可以明确显示胸部病变类型,为诊断及鉴别诊断提供线索。

Chest CT diagnosis and differential diagnosis of fever patients in emergency department

Objective To analyze the clinical features and chest CT abnormalities of fever patients in emergency department,and to improve the diagnosis of such patients. Methods A total of 109 hospitalized patients,who complained of fever in emergency department,with severe clinical symptoms and chest CT abnormalities and poor therapeutic effect of conventional anti- infective therapy,were enrolled and studied retrospectively. Results Elderly patients were more seen in such patients,and they often accompanied with chronic diseases and severe pneumonia. Their prognosis was relatively poor. The main cause of fever was infectious diseases,with the main CT abnormalities of ground- glass attenuations,consolidations and pleural effusion. The main CT abnormality of non- infectious diseases was pleural effusion. Conclusion The clinical and imaging findings are complex for patients with fever and chest disease. The chest CT can clearly show the different type of abnormalities and can provide clues for diagnosis and differential diagnosis.