Analysis On Dynamic Changes In Lung HRCT Findings And Lung Function Of Paraquat Poisoning Patients

Background:Paraquat have high toxicity to human body. Paraquat oral enter the body can cause poisoning, can cause the body to multisystem damage, its poisoning is the most serious and the characteristic of change is lung damage, light chest tightness, shortness of breath, chest pain, severe cyanosis, dyspnea, severe respiratory failure and death can result, this performance was named "paraquat lung", is a variant form of acute respiratory distress syndrome (ARDS), is the main cause of death in paraquat poisoning patients. The image can be a direct reflection of lung damage condition, changes in lung tissue by imaging can assess the progress of lung lesions, lung injury and determine the prognosis of the patient. A lot of studies and reports on the mechanism of paraquat poisoning, treatment, prognostic factors and recent lung injury, but the treatment of survival patients with lung injury to the recent recovery is little, long-term lung acute lung injury paraquat poisoning patients are lack of a complete dynamic evolution of the long-term of the survival patient’s quality of life, lack of basic assessment. In this study, Qilu Hospital by reviewing a comprehensive program of treatment given to37cases of acute paraquat poisoning survivors were poisoned and3months after treatment (20weeks) follow-up analysis of lung HRCT findings and lung function data, and evaluate the extent of lung injury, help to find new ways to treat lung injury in the process.Objective:By retrospective analysis37cases of paraquat poisoning survivors of Shandong University Qilu Hospital of poisoning and diseases department, from January2013to January2014, analysis the survived changes in clinical data in patients with HRCT findings and lung function, aims to explore the clinical significance of lung injury and prognosisthe on different periods of paraquat poisoning patients.Methods:A retrospective analysis on37cases of paraquat poisoning survivors of Shandong University Qilu Hospital of poisoning and diseases department, analysis on the survival of patients with clinical data, and collect the first1,3,7,14,21day and8weeks,20weeks lung HRCT imaging and the first21days of poisoning patients,8weeks,20weeks pulmonary function tests, and analysis these early, middle, late, long-term results.Results:1lung HRCT37cases poisoning patients of lung HRCT imaging are mainly for no obvious lesions, exudative lesions (including ground-glass opacity, patchy high density? flocculent shadow and opacities), pleural effusion (in some cases with adjacent lung tissue atelectasis), pleural thickening, high density cable strip, interstitial lesions in some cases accompanied by pericardial effusion, cardiac density reduce other symptoms.Patients with mild from the onset to long-term recovery, lung HRCT imaging was no significant lesions. Patients with severe with exudative lesions forward early, middle, late compare P<0.05, statistically significant; pleural effusion relatively long-term and post-P>0.05, not statistically significant; and the early, middle, P<0.05, statistically significant; pleural thickening forward with early, middle, late compare all P<0.05, statistically significant; cable strip long-term and high-density early, middle, late compare all P<0.05, statistics significance; interstitial lesions forward with earlier comparative P<0.05, statistically significant, and the medium-term post-comparison P>0.05, not statistically significant.2Pulmonary function 37cases of patients with pulmonary function tests, mainly for roughly normal lung function, mild restrictive ventilatory dysfunction merge diffusion barriers.Pulmonary function abnormalities rate of mild poisoning group compared with the severe poisoning group P<0.05, statistically significant; The indicators of lung function in patients with severe group compared with patients with mild, FEV1.0/FVC%, TLCOSB, VC, TLC, FVC, FEV1.0all P<0.05, there is statistical significance;20weeks and8weeks,3weeks is normal and abnormal group P<0.05, there is statistical significance; Restrictive ventilatory disorder with obstructive ventilation dysfunction in8and20weeks compared with3weeks P<0.05, with statistical significance..3. Physical load resistancePhysical load resistance can be performed, daily activities is not restricted, limited daily activities, can’t do any physical activity.Severe poisoning group physical tolerance comparison over time P<0.05, with statistical significanceConclusion:1. PQ poisoning patients presenting dynamic changes in lung HRCT:With mid-term progress of the disease, lung can have a large area of exudation and even consolidation, pleural effusion, pulmonary bulla, pulmonary nodules; late exudative pleural effusion shadow and most improved, can be left high density streak between shadow and limitations of qualitative changes in long-term survival of patients, between high density streak and limitations of qualitative change with time better.PQ poisoning patients with mild poisoning group under the Integrated Programme therapy, since the onset of treatment and long-term recovery, lung HRCT shows rare diseases; under the integrated program for therapy, lung HRCT in the early course of the disease can be more severe group PQ poisoning patients kinds of lesions exist, such as exudative lesions, pleural thickening, high density cable strip.2. long-term survival in patients with abnormal lung function partially present, patients with mild and severe patients are ventilatory defect, but a few patients with diffuse lung disorders, obstructive ventilatory dysfunction and in patients with moderate to severe degree of diffusion barriers significantly lesser degree. With the extension of abnormal lung function, lung HRCT turn around time and improved.3. PQ poisoning patients was reversible pulmonary fibrosis, pulmonary function with prolonged therapy and pulmonary fibrosis reduction and improved.