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    #54. Fashion design

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    #16. Occupational health and safety

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    2023-04-01 10:38:54梅斯医学
    核心提示:在美国境内已报告有2668例由于电子烟或雾化产品相关的肺损伤(EVALI)病例,其中60例确认死亡,18岁以下的患者占报告的15%。

    电子烟于2007年左右首次在美国推出,自2014年以来,电子烟已成为美国青少年最常用的烟草产品,且在过去几年里在青少年中的使用大幅增加。自2012起,在一些病例报告中开始提出有关使用电子烟与肺损伤之间存在联系的可能性。截至2023-04-01,在美国境内已报告有2668例由于电子烟或雾化产品相关的肺损伤(EVALI)病例,其中60例确认死亡,18岁以下的患者占报告的15%。

    影像学在EVALI的早期检测和进展评估中起着至关重要的作用。在成人人群中,已有相关系列病例报告描述了EVALI的临床和影像学表现。然而据我们所知,目前尚无关于小儿EVALI患者胸部x线和CT表现的相关研究。

    近日,发表在Radiology杂志的一项研究评估了儿童人群中EVALI的胸部x线和CT表现,为临床深入了解EVALI在儿童人群中的病理生理,并进一步引起人群对EVALI的重视提供了数据支持。

    本项回顾性研究的研究对象为2018年12月至2019年12月期间在三级儿科医院就诊的儿童。每位患者均符合美国疾病控制和预防中心对EVALI的标准,初次就诊时均具备胸部x线和CT图像。由两位儿科专业放射科医师独立审查了肺内和肺外异常的模式、分布和程度。对临床信息、治疗和预后进行了回顾。使用Cohen κ系数测定观察者间的一致性。

    本研究共纳入男性患者7例(50%),女性患者7例(50%)(平均年龄16岁;范围为13-18年)。所有患者均在就诊后4天(范围0-4天)内接受胸部x线片和CT检查。胸部x线表现包括14/14(100%)的磨玻璃影和8/14(57%)的实变。CT表现包括4/14(100%)毛玻璃样影,9/14(64%)实变,2/14(14%)小叶间隔增厚。在CT上,11/14例(79%)出现胸膜下不累及,5/14例(36%)出现反晕征。胸部x线及CT的异常表现14/14(100%)以双侧为主,13/14(93%)以对称为主,7/14(50%)以下叶为主。在胸部x线和CT上异常表现的程度以弥漫性为主。两位阅读者对胸片(κ = 0.99;95%置信区间:0.97,1.00)和CT (κ = 0.99;95%置信区间:0.98,1.00)异常表现的检测几乎是完全一致的。

    本研究结果表明电子烟或雾化产品相关的肺损伤(EVALI)的儿科患者的影像学表现以双侧对称磨玻璃影为特征,伴有实变,且通常以下叶为主。在CT上,常出现胸膜下不累及的表现,且反晕征(环礁征)是一个特征性表现。本研究为临床上早期诊断及干预EVALI提供参考依据。

    原文出处:

    Maddy Artunduaga,Devika Rao,Jonathan Friedman,et al.Pediatric Chest Radiographic and CT Findings of Electronic Cigarette or Vaping Product Use-associated Lung Injury (EVALI).DOI:10.1148/radiol.2020192778

    39健康网专业医疗保健信息平台 优质健康资讯门户网站    

    中国领先的健康门户网站,中国互联网百强,于2023-04-01开通,中国历史悠久、规模最大、拥有丰富内容与庞大用户的健康平台。多年来,在健康资讯、名医问答、就医用药信息查询等方面持续领先,引领在线健康信息,月度覆盖超4亿用户。

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    39热文一周热点
    肺损伤
    • 红霉素肠溶片

      1.本品可作为青霉素过敏患者治疗下列感染的替代用药:溶血性链球菌、肺炎链球菌等所致的急性扁桃体炎、急性咽炎、鼻窦炎;溶血性链球菌所致猩红热、蜂窝织炎;白喉及白喉带菌者;气性坏疽、炭疽、破伤风;放线菌病;梅毒;李斯特菌病等; 2.军团菌病; 3.肺炎支原体肺炎; 4.肺炎衣原体肺炎。 5.衣原体属、支原体属所致泌尿生殖系感染; 6.沙眼衣原体结膜炎; 7.淋病奈瑟菌感染;[详细]

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    • 红霉素肠溶片

      1.本品可作为青霉素过敏患者治疗下列感染的替代用药:溶血性链球菌、肺炎链球菌等所致的急性扁桃体炎、急性咽炎、鼻窦炎;溶血性链球菌所致猩红热、蜂窝织炎;白喉及白喉带菌者;气性坏疽、炭疽、破伤风;放线菌病;梅毒;李斯特菌病等; 2.军团菌病; 3.肺炎支原体肺炎; 4.肺炎衣原体肺炎。 5.衣原体属、支原体属所致泌尿生殖系感染; 6.沙眼衣原体结膜炎; 7.淋病奈瑟菌感染; [详细]

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    • 红霉素肠溶胶囊

      本品主要用于金黄色葡萄球菌、肺炎链球菌、其他链球菌属等G+敏感菌引起的扁桃体炎、肺炎、猩红热、白喉及带菌者、淋病等感染;也可用于流感杆菌引起的上呼吸道感染(如耳、鼻、咽喉感染等)、金葡菌引起的皮肤及软组织感染、梅毒、肠道阿米巴病等。 本品可作为军团病、支原体肺炎等的首选药。[详细]

      去看看 ¥31.85
    擅长肺损伤专家更多
    • 陈新副主任医师南方医科大学珠江医院

      擅长领域:在慢性阻塞性肺疾病、支气管哮喘、急性肺损伤、呼吸衰竭机械通气、肺部疾病的介入诊疗等方面具有较为丰富的理论基础和临床经验。

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