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頁籤選單縮合
題名 | Acute Interstitial Pneumonia--Report of Two Cases=急性間質性肺炎--二病例報告 |
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作者 | 黃恆慶; 陳芬芬; 陳炯睿; 朱遠志; 薛尊仁; | 書刊名 | 胸腔醫學 |
卷期 | 16:1 2001.03[民90.03] |
頁次 | 頁50-56 |
分類號 | 415.463 |
關鍵詞 | 急性間質性肺炎; Hamman-rich症候群; 急性呼吸窘迫症候群; Acute interstitial pneumonia; Hamman-rich syndrome; Acute respiratory distress syndrome; |
語文 | 英文(English) |
中文摘要 | 急緎間質性肺炎亦稱Hamman-Rich症候群,是一未知病因的猛爆性病疾病。通常發生在原先健康的病人,而以快速惡化的呼吸困難來表現。由於急性呼吸衰竭,一般需要機械性輔助呼吸。此病之死亡率高,大部分病人會於發病後六個月內死亡。我們報告最近經由臨床症狀與病理切片發現確定診斷之二病例。兩位病患,一位為53歲男性,一位為68歲女性,先前圾無任何病史,發病後病況均相當嚴重,且接受抗生素、類固醇及機械性輔助呼吸治療。肺切片檢查均發現肺實質之纖維母細胞增生,肺泡大小不一且有上皮增生及鱗狀化生之現象,且沒有任何濾過性病毒感染之跡象。其中一位病人經治療後存活,但仍需呼吸器支持;因一位病人則於發病三週後死亡。此病之治療方式尚未確立,一般性支持及類固醇仍是主要治療方式。至於真正的治療機轉則仍須進一步的研究探討。 |
英文摘要 | Acute interstitial pneumonia (AIP), synonymous with Hamman-Rich syndrome, is a fulminant disease of unknown etiology. It usually occurs in a previously healthy person and presents with rapidly progressive dyspnea. Mechanical ventiliation is often needed due to acute respiratory failure. Mortality is high, and the majority of patients die within 6 months of presentation. Recently, we experienced two patients with acute interstitial pneumonia diagnosed by clinical mainifestations and pathological findings. both patients were previously healthy, with no evidence of previous pulmonary or collagen vascular disease, exposure to toxic agents, or prior hypotensive episode. They became critically ill and were treated intesively with various antibiotics, corticosteroids, and mechanical ventilation. Open lung biopsies in these two patients all showed that there was a proliferation of fibroblasts and monomuclear cells in the lung parenchyma. The alveolar spaces were different in size and revealed epithelial hyperplasia and squamous metaplasia. One patient survived ventilator dependent, and the other expired after three weeks of presentation. The definitive treatment for the disease has not yet been established, but general support and corticosteroids are still the main modalities of treatment. Further studies are needed to evaluate the exact pathgenesis. |
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