中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2013年
10期
1609-1610
,共2页
蝇蛆病%肺嗜酸细胞增多症%误诊%结核%肺
蠅蛆病%肺嗜痠細胞增多癥%誤診%結覈%肺
승저병%폐기산세포증다증%오진%결핵%폐
Myiasis%Pulmonary eosinophilia%Misdiagnosis%Pulmonary tuberculosis
目的：：通过对蝇蛆病合并肺嗜酸细胞增多症误诊为肺结核的原因分析，提高对两种疾病的鉴别诊断能力。方法：采用回顾性调查研究的方法，采集2002年2月~2012年12月住院并经临床及实验室检查证实的蝇蛆病合并肺嗜酸细胞增多症误诊肺结核患儿11例，对其病史资料、临床表现、实验室检查、临床治疗及预后进行回顾性分析，找出误诊原因。结果：误诊肺结核的蝇蛆病合并肺嗜酸细胞增多症患者最常见的症状为咳嗽、咳黏痰、胸痛及低热、乏力、盗汗等全身中毒症状，皮下游走性疖肿及匍行疹，病程常超过3周。胸部X线、CT表现多种多样。结论：痰结核菌阴性而临床症状和X线表现与肺结核相似，经正规抗结核治疗后仍反复发作或无效，病程中有游走性疖肿及匍行疹的患者，应考虑到肺嗜酸细胞增多症。
目的：：通過對蠅蛆病閤併肺嗜痠細胞增多癥誤診為肺結覈的原因分析，提高對兩種疾病的鑒彆診斷能力。方法：採用迴顧性調查研究的方法，採集2002年2月~2012年12月住院併經臨床及實驗室檢查證實的蠅蛆病閤併肺嗜痠細胞增多癥誤診肺結覈患兒11例，對其病史資料、臨床錶現、實驗室檢查、臨床治療及預後進行迴顧性分析，找齣誤診原因。結果：誤診肺結覈的蠅蛆病閤併肺嗜痠細胞增多癥患者最常見的癥狀為咳嗽、咳黏痰、胸痛及低熱、乏力、盜汗等全身中毒癥狀，皮下遊走性癤腫及匍行疹，病程常超過3週。胸部X線、CT錶現多種多樣。結論：痰結覈菌陰性而臨床癥狀和X線錶現與肺結覈相似，經正規抗結覈治療後仍反複髮作或無效，病程中有遊走性癤腫及匍行疹的患者，應攷慮到肺嗜痠細胞增多癥。
목적：：통과대승저병합병폐기산세포증다증오진위폐결핵적원인분석，제고대량충질병적감별진단능력。방법：채용회고성조사연구적방법，채집2002년2월~2012년12월주원병경림상급실험실검사증실적승저병합병폐기산세포증다증오진폐결핵환인11례，대기병사자료、림상표현、실험실검사、림상치료급예후진행회고성분석，조출오진원인。결과：오진폐결핵적승저병합병폐기산세포증다증환자최상견적증상위해수、해점담、흉통급저열、핍력、도한등전신중독증상，피하유주성절종급포행진，병정상초과3주。흉부X선、CT표현다충다양。결론：담결핵균음성이림상증상화X선표현여폐결핵상사，경정규항결핵치료후잉반복발작혹무효，병정중유유주성절종급포행진적환자，응고필도폐기산세포증다증。
Objective:To improve differential diagnosis ability of myiasis with pulmonary eosinophilia and pulmonary tuberculosis through analyzing the reason of misdiagnosis between myiasis with pulmonary eosinophilia and pulmonary tuberculosis.Methods:Using the method of retrospective study,retrospectively reviewed the medical records of 11 myiasis with pulmonary eosinophilia cases which were confirmed by clinical and lab test and were misdiagnosed as pulmonary tuberculosis from February 2002 to December 2012.Their clinical features, laboratory investigations,treatment and prognosis were analyzed,find out the causes of misdiagnosis.Results:The symptoms of myiasis with pulmonary eosinophilia misdiagnoses as pulmonary tuberculosis including coughing,mild phlegm,chest pain,breathlessness, dyspnea,lowgrade fever,hypodynamia and night sweat,subcutaneous migration furunale and creeping eruption.The duration of the disease was more than three weeks.The thoracicX-ray and CT manifestations were multifarious. Conclusion:The reason of misdiagnosis is lack of knowledge of myiasis with pulmonary eosinophilia.We should be alert to myiasis with pulmonary eosinophilia that sputum examination is negative, in the course of a migration furunale and creeping eruption,clinical symptom and chest X-ray examination is similar as tuberculosis,but relapses or has no effect after regular therapy.
