临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
2期
37-39
,共3页
哮喘%咳嗽%误诊%支气管炎%呼吸道感染
哮喘%咳嗽%誤診%支氣管炎%呼吸道感染
효천%해수%오진%지기관염%호흡도감염
Asthma%Cough%Diagnostic error%Bronchitis%Respiratory tract infection
目的:探讨咳嗽变异型哮喘( cough variant asthma, CVA)的临床特点、误诊原因及防范措施。方法对我院2013年1月—2014年1月收治的70例CVA误诊病例的临床资料进行回顾性分析。结果本组表现为刺激性咳嗽或干咳49例,凌晨和(或)夜间咳嗽40例,咳嗽伴少量黏痰19例,胸闷14例。误诊为支气管炎29例(41.4%),急性上呼吸道感染14例(20.0%),扁桃体炎10例(14.3%),慢性咽炎7例(10.0%),百日咳3例(4.3%),支原体肺炎3例(4.3%),肺门淋巴结结核2例(2.9%),支气管异物2例(2.9%)。误诊时间29 d~1年。70例按误诊疾病治疗效果均不明显,入我院后经综合分析病史、临床表现及医技检查结果符合CVA诊断标准确诊。予相应治疗3~28 d症状消失。结论 CVA临床表现具有一定隐匿性,极易发生误诊。加强对CVA认识、详细病史询问、综合全面病情分析和及时进行相关医技检查可减少或避免其误诊。
目的:探討咳嗽變異型哮喘( cough variant asthma, CVA)的臨床特點、誤診原因及防範措施。方法對我院2013年1月—2014年1月收治的70例CVA誤診病例的臨床資料進行迴顧性分析。結果本組錶現為刺激性咳嗽或榦咳49例,凌晨和(或)夜間咳嗽40例,咳嗽伴少量黏痰19例,胸悶14例。誤診為支氣管炎29例(41.4%),急性上呼吸道感染14例(20.0%),扁桃體炎10例(14.3%),慢性嚥炎7例(10.0%),百日咳3例(4.3%),支原體肺炎3例(4.3%),肺門淋巴結結覈2例(2.9%),支氣管異物2例(2.9%)。誤診時間29 d~1年。70例按誤診疾病治療效果均不明顯,入我院後經綜閤分析病史、臨床錶現及醫技檢查結果符閤CVA診斷標準確診。予相應治療3~28 d癥狀消失。結論 CVA臨床錶現具有一定隱匿性,極易髮生誤診。加彊對CVA認識、詳細病史詢問、綜閤全麵病情分析和及時進行相關醫技檢查可減少或避免其誤診。
목적:탐토해수변이형효천( cough variant asthma, CVA)적림상특점、오진원인급방범조시。방법대아원2013년1월—2014년1월수치적70례CVA오진병례적림상자료진행회고성분석。결과본조표현위자격성해수혹간해49례,릉신화(혹)야간해수40례,해수반소량점담19례,흉민14례。오진위지기관염29례(41.4%),급성상호흡도감염14례(20.0%),편도체염10례(14.3%),만성인염7례(10.0%),백일해3례(4.3%),지원체폐염3례(4.3%),폐문림파결결핵2례(2.9%),지기관이물2례(2.9%)。오진시간29 d~1년。70례안오진질병치료효과균불명현,입아원후경종합분석병사、림상표현급의기검사결과부합CVA진단표준학진。여상응치료3~28 d증상소실。결론 CVA림상표현구유일정은닉성,겁역발생오진。가강대CVA인식、상세병사순문、종합전면병정분석화급시진행상관의기검사가감소혹피면기오진。
Objective To investigate the clinical characteristics, misdiagnosis and preventive measures of children with cough variant asthma. Methods 70 children with cough variant asthma admitted to our hospital during January 2013 and January 2014 were chosen. The clinical data were retrospectively analyzed. Results 49 cases of this group were found to have irritating cough or dry cough, 40 cases of early in the morning and ( or) nighttime cough, 19 cases of cough with a small amount of mucus, 14 cases of dyspnea. 29 (41. 4%) cases were misdiagnosed as bronchitis, 14(20. 0%) cases as acute up-per respiratory tract infection, 10 (14. 3%) cases as tonsillitis, 7(10. 0%) cases as chronic pharyngitis, 3(4. 3%) cases as whooping cough, 3 ( 4. 3%) cases as mycoplasma pneumoniae, 2 ( 2. 9%) cases as hilar lymph node tuberculosis, 2 (2. 9%)cases as bronchial foreign bodies. Misdiagnosed time was 29 d-1 year. 70 cases of misdiagnosis showed no significant treatment effect. After admition a comprehensive analysis of history, clinical manifestations and medical tests were performed. CVA was confirmed after diagnostic criteria were met. After treatment for 3-28 d, symptoms disappeared. Conclusion CVA has some occult clinical manifestations, and is prone to misdiagnosis. Awareness of CVA, detailed medical history inquiry, a comprehensive analysis of the disease, timely medical and technological examinations can reduce or avoid misdiagnosis.