胸腔积血

Methods Fiftythree patients with SAP admitted from 1995 to 1999 was categorized as group 1, and 57 patients admitted from 2000 to 2005 as group 2, were analyzed retrospectively. Ranson′s score, acute physiological and chronic health evaluationⅡ score, Balthazar CT grade, presence or absence of biliary tract obstruction, hypoxia, lung infection, shock, abdomen compartment syndrome, hyperlipemia, pleural effusion were analysed logistically. Mortality following different treatments and incidence rate of complications were also evaluated.

回顾性分析安徽省立医院1995—1999年收治的53例SAP患者(第1组)和2000—2005年收治的57例SAP患者(第2组)临床资料，对患者Ranson评分、急性生理学与慢性健康状况评分Ⅱ、Balthazar CT分级以及是否伴有胆道梗阻、休克、高脂血症、腹腔间隙综合征、低氧血症、肺部感染、胸腔积液等因素进行多因素Logistic回归分析，分析不同治疗方法对并发症发生率和病死率的影响。

The right lung is atelectatic and floating in bloody fluid filling the right chest cavity as a consequence of trauma. This is a hemothorax .

图示的是外伤引起的右侧肺不张，肺组织飘浮在右侧胸腔的血性液体内，这是胸腔积血的病例。

As compared with the tradition opening thorax operation, it's shorter than the before time of operation and being in hospital, the wound less than before, better economy, and direct exscinded pathological changes pleura below the orthoptic contemplation then delivered for the examining.

应用胸腔镜治疗血胸、胸腔积液疗效肯定，较传统开胸手术时间短，住院时间短，创伤小，经济，并能在直视下切取病变胸膜活检。

Results There were 95 cases of fracture of rib,28 cases of haemothorax,8 cases of hydropneumothorax,8 cases of pneumatothorax,67 cases of pulmonary contusion,18 cases of traumatic pulmonary aerocyst,12 cases of pulmonary hematoma,one case of bronchial rupture and one case of diaphragmatic rupture in our group.

结果 肋骨骨折95例，胸腔积血28例，液气胸8例，气胸8例，肺挫伤67例，创伤性肺气囊18例，肺血肿12例，支气管断裂和膈肌破裂各1例。

The symptoms of pulmonary blastoma were fever and hemoptysis. X-ray or CT scan showed an isolated mass in the lung, with uneven density. Malignant cells in pleural effusion were found in one case and can not be diagnosed deficnely but by pulmonary puncture.

肺母细胞瘤表现为发热（2/2）、咯血（1/2），X线及CT表现为肺内肿块，密度不均匀，1例胸腔积液中查见恶性肿瘤细胞，无法确诊，行肺穿刺活检确诊。1例行肺叶切除术后病理确诊，全组术后随访15例（2例癌肉瘤失访），随访率88%。

The symptoms of pulmonary blastoma were fever and hemoptysis. X-ray or CT scan showed an isolated mass in the lung, with uneven density. Malignant cells in pleural effusion were found in one case and can not be diagnosed definetely but by pulmonary puncture.

肺母细胞妻子瘤表现为发热（2/2）、咯血（1/2），X线及CT表现为肺内肿块，密度不均匀，1例胸腔积液中查见恶性肿瘤细胞妻子，无法确诊，行肺穿刺活检确诊。1例行肺叶切除术后病理确诊，全组术后随访15例（2例癌肉瘤失访），随访率88%。

sick euthyroid syndromeshould be often found in patients with critical trauma,but it is commonly confused ses with retention of fluid in third space after fluid resuscitation or with lowed colloid osmotic pressure as result of hypoproteinemia in the clinic.serious ses is presented an edema of face and all over,non blood fluid draining out of the needle hole,the wound not healing desiredly with fluid oozing unexpectedly,or pleural effusion on both sides,or pericardial effusion.the pathogenesis of ses is incompletely understood.the inflammatory cytokines are generally accepted as an important pathogenic factor of ses.

甲状腺功能正常性病变综合征（sick euthyroid syndrome，ses）在危重创伤患者中并不少见，严重者表现为颜面及全身肿胀，针眼可见持续的非血性液体流出，伤口渗液较多不易预期愈合，双侧胸腔积液或心包积液等。临床上常与液体复苏后的第三间隙液体潴留、低蛋白血症致胶体渗透压降低等的临床表现相混淆，很容易被忽略。其发病机制还不十分清楚，众多的研究首先考虑的致病因素是炎性因子。

Results CT scans clearly showed lung contusions in 117,lung laceration and haematoma in 19,atelectasis in 24, haemothroax in 67, pneumothorax in 45, hemopneumothorax in 52, mediastinum haematoma in 7, pneumomediastinum in 8,pneumoderma in 25, diaphragmatic hernia in 17, fracture of rib in 103, and flail chest in 34 fractures.

结果诊断肺挫伤117例，肺挫裂伤及肺内血肿19例，肺不张24例，血胸67例，气胸45例，血气胸52例，纵隔血肿7例，纵隔积气8例，皮下气肿25例，膈疝17例，肋骨骨折103例，连枷胸34例。143例（84.1％）经非手术处理，其中43例行胸腔闭式引流术，22例行机械呼吸支持。

Resujts:① The distribution of lesions are mostly symmetrical, extensive, predominant in the middle and lower lung fields, and posterior areas in peripheral;② There are so many HRCT findings of lung, ILD is predominant: intralobular interstitial thickening 46 cases (100%), ground-glass opacity 41 cases (89.13%), peribronchovascular or centrilobular interstitial thickening 40 cases (86.96%), interlobular septal thickening 38 cases (82.61%), irregular linear opacity 37 cases (80.43%), small nodular opacity 34 cases (73.91%), subpleural line 27 cases (58.70%), bmnchiectasis or bronchiolectasis 19 cases (41.30%), patch opacity 18 cases (39.13%), expiratory mosaic sign 15 cases (32.61%), interface sign 14 cases (30.43%), honeycombing 12 cases (26.09%), emphysema or bulla 3 cases, cystic airspace suspected 1 case, and atelectasis suspected 1 case;③ Mediastinum and pleura: multiple small lymphonodi in mediastinum 41 cases (89.13%), pleural thickening or rough 38 cases (82.61%), esophagoectasis 11 cases (23.91%), unilateral little pleural fluid 1 case, and mediastinal emphysema 1 case.

结果：①皮肌炎肺部病变分布呈对称、广泛、偏中下、偏外后的特点；②肺部HRCT表现多样，以肺间质性改变为主：小叶内间质增厚46例(100%)，磨玻璃影41例(89.13%)，支气管血管束增宽或小叶核心增大40例(86.96%)，小叶间隔增厚38例(82.61%)，不规则纤维索条影37例(80.43%)，结节影34例(73.91%)，胸膜下线27例(58.70%)，支气管或细支气管扩张19例(41.30%)，斑片影18例(39.13%)，呼气相马赛克征15例(32.61%)，界面征14例(30.43%)，蜂窝影12例(26.09%)，肺气肿或肺大泡3例，单纯囊状气腔1例，肺不张l例；③纵隔及胸膜：纵隔小淋巴结影41例(89.13%)，胸膜增厚或毛糙38例(82.61%)，食管扩张11例(23.91%)，单侧少量性胸腔积液1例，纵隔气肿1例。

19 Cases complicated with dropsy and haematocele in the pericardium, mediastinum and thorax.

并发心包、纵隔及胸腔积液和积血共19例。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。