胸膜内炎性并发症的诊断

E. V. Kosov, O. Rozhkova, Victor Veklych, Nikita Barsukov
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引用次数: 0

摘要

创伤后胸腔化脓性并发症临床症状的非特异性表明仪器诊断方法的重要性。目前还没有普遍接受的算法来检查胸部受伤的人,以便及时识别创伤后时期的化脓性并发症。本文介绍了胸部损伤胸膜内并发症患者的螺旋ct检查结果,该方法可以客观地记录病理过程的动态,评估治疗的有效性,及时诊断继发性并发症。Тhe对研究结果的分析表明,需要对疑似创伤后胸膜内并发症进行全面检查。胸部病变患者创伤后出现全身性炎症反应时,无论x线检查、超声检查和胸部ct检查结果如何,均应行胸膜和心包腔内病理内容物的积累,评估肺组织、纵隔、胸壁的性质变化,判断病变溃烂引流。同时,为了正确解释螺旋ct上的一些变化,包括在肺出血和纵隔炎背景下发生的肺脓肿,而不是在纵隔出血和纵隔气肿背景下发生的肺脓肿,有必要将其与基线数据进行比较。这证明了在复查x线上出现任何局灶性改变的胸部病变患者进行早期螺旋ct检查的必要性。胸部动态螺旋ct可以客观记录病理过程的动态,评价治疗效果,及时诊断继发性并发症。该算法的应用可以在早期诊断全谱胸膜内并发症,避免诊断错误
本文章由计算机程序翻译,如有差异,请以英文原文为准。
DIAGNOSTICS OF INFLAMMATORY INSIDE THE PLEURAL COMPLICATIONS OF THORACIC INJURY
The non-specificity of the clinical signs of posttraumatic purulent thoracic complications indicates the importance of instrumental diagnostic methods. There is no generally accepted algorithm for examining an injured person with a chest injury that would allow timely recognition of purulent complications in the posttraumatic period. The results of the examination of patients with intra-pleural complications of thoracic injury using the spiral computed tomography method, which in dynamics allows objectively documenting the dynamics of the pathological process, evaluating the effectiveness of treatment, timely diagnose secondary complications, are presented. Тhe analysis of the results of the study indicates the need for a comprehensive examination of suspected post-traumatic intra pleural thoracic complications. In the presence of any manifestations of systemic inflammatory response in the posttraumatic period in patients with chest lesions, regardless of the results of the X-ray examination, ultrasound examination and computed tomography of the chest should be performed, which allows to detect the accumulation of pathological contents in the pleural and pericardial cavity, to assess the nature changes in the pulmonary tissue, mediastinum, thoracic wall and decide on the drainage of lesions fester. At the same time, for the correct interpretation of some changes in spiral computed tomography, including the lung abscess that developed in the background of pulmonary hemorrhages and mediastinitis against the background of hemorrhages in the mediastinum and pneumomediastinum, it is necessary to compare them with the baseline data. This testifies to the necessity of performing an early spiral computed tomographic examination in patients with chest lesions in the presence of any focal changes on the review X-ray. Spiral computer tomography of the chest in dynamics allows to objectively document the dynamics of the pathological process, evaluate the effectiveness of treatment, timely diagnose secondary complications. The application of this algorithm allows to diagnose the entire spectrum of intra-pleural complications in the early stages and to avoid diagnostic errors
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