目的观察肺结核空洞性病变的发生及其临床、影像学表现,探讨其发病和病理演变机制的变化与特征。资料与方法搜集本院161例空洞性肺结核患者的临床和CT检查资料。分析各类空洞病变的发生率、形态特征及其与发病年龄、发病时间、伴随征象和细菌学检查结果等临床因素的关系。结果161例中厚壁空洞133例(82.6%)、薄壁空洞13例(8.1%)、无壁空洞15例(9.3%)。120例为新发病例。患者从出现症状到CT检查的时间间隔为4h～317天,将120例新发病例分为急性、亚急性和慢性发病组。无壁空洞全部分布于急性和亚急性组,薄壁空洞仅见于急性组,厚壁空洞在各组均有分布。三种类型空洞在各组间的分布差异有统计学意义(P<0.05)。127例空洞伴有“树芽征”(78.9%),三种空洞伴发“树芽征”的比率差异有统计学意义(P<0.05)。结论肺结核空洞性病变发病率增高且越来越多地产生于肺实变基础上的迅速坏死,其发生方式和影像学变化反映了现代肺结核的发病及其病理演变的新特征。 Objective To observe the occurrence and clinical and imaging findings of pulmonary tuberculosis and explore the changes and characteristics of its pathogenesis and pathogenesis. Materials and Methods Clinical and CT examination data of 161 patients with empty tuberculosis in our hospital were collected. Analysis of the incidence of various types of cavity lesions, morphological characteristics and its relationship with the age of onset, onset time, accompanying signs and bacteriological findings and other clinical factors. Results Of 161 cases, 133 cases were moderate-thick-wall hollows (82.6%), 13 cases were thin-wall hollows and 8.1 cases were non-wall-hollows. 120 cases of new cases. Patients from symptoms to CT examination interval of 4h to 317 days, the 120 cases of new cases were divided into acute, subacute and chronic disease group. All of the wallless cavities were located in the acute and subacute groups, while the thin-walled cavities were found only in the acute group, while the thick-wall cavities were distributed in all groups. There were significant differences in the distribution of the three types of voids between groups (P <0.05). There were significant differences (P <0.05) in the ratio of “hole buds” and “hole buds” among the 127 cases with the “tree bud buds” (78.9%). Conclusions The incidence of pulmonary tuberculosis increased and more and more rapidly developed on the basis of pulmonary consolidation. The occurrence and imaging changes reflect the new features of modern tuberculosis and its pathological changes.