肺结核126例误诊分析

目的 :探讨肺结核漏误诊原因。方法 :对 12 6例各型肺结核在误诊时的症状、体征、胸片、CT片及误治后的病情进行分析。结果 :初次患Ⅰ、Ⅱ、Ⅲ型肺结核的病人中 38例 (30 15 % )误诊为上呼吸道感染、气管炎、慢性支气管炎 ,2 7例 (2 1 43% )误诊为肺炎、肺部感染 ,17例 (13 49% )误诊为支气管扩张 ,12例 (9 5 % )误诊为肺脓肿 ,9例 (7 14% )误诊为肺癌 ,9例合并肠结核、腹腔结核病人误诊为肠炎、痢疾、阑尾炎 ,4例误诊为颈淋巴结炎 ,其余误诊为风湿病 2例、关节炎 2例、营养不良 2例、肾结石 3例、周围性面瘫 1例。误诊时间在 2mon～ 2a多不等。结论 :肺结核发病形式多样化 ,临床表现、胸片常不典型 ,尤其是医务人员警惕性不高 ,不重视胸片、痰结核菌及其免疫学检查、纤支镜、病理学检查 ,没有综合系统的分析病情 ,是造成误诊的主要原因

Analysis of misdiagnosis on 126 cases of pulmonary tuberculosis

Objective:Explore reasons causing pulmonary tuberculosis have been misdiagnosed.Methods:We have analyzed clinical symptoms,chest X ray films,CT and state of an illness for 126 cases of pulmonary ruberculosis which have been misdiagnosed.Results:In the middle of the patient suffering from Ⅰ、Ⅱ、Ⅲ model plulmonary tuberculosis for the first time,38 cases have been misdiagnosed as upper respiratory tract infection,trachitis,chronic bronchitis,27 cases as pneumonia,17 cases as bronchus dilation,9 cases as lung cancer,9 cases as enteritis,dysentery,appendictis,4 cases as lymphadenitis colli,others as rheumatism,arthritis,poor mourishment,kidney stone,Delay diagnosis of time for 2 month～ 2years.Conclusions:Coming on form of pulmonary tuberculosis is diverse,clinical symptons and chest X ray films frequently isn't typical.Especially,there are not high vigilance and it isn't importance to chest X ray films,phlegm tubercle bacillus and immunology,fiber bronchus mirror,pathology examine for doctor.There aren't synthetically analyzed for state of an illness.These are main reason for working delay diagnosis.