12例呼吸道异物的误诊原因分析

本文报告两所医院13年所误诊的呼吸道异物12例,占同期所收治的呼吸道异物的15.4%。误诊的原因:(1)不重视异物吸入史或病史不详,仅以异物引起的继发性病变作诊断;(2)对呼吸道异物的 X 线诊断方法和基本特征认识不足;(3)有异物吸入史,但 X 线检查报告正常;(4)呼吸道确有异物,而支气管镜检未发现;(5)多发性异物。并针对每项误诊原因提出注意事项。

ANALYSIS OF THE REASONS FOR THE MISDIAGNOSIS OF ASPIRATED FOREIGN BODIES IN RESPIRATORY TRACT

In this report,12 cases of misdiagnosed aspirated foreign bodies in the respiratory tract are presented.They were collected from the two affiliated hospitals of our college,within the period of 13 years. Considering the total cases of aspirated foreign body in the respi- ratory tract administered at the same period,the misdiagnosed cases occupied a percentage of 15.4. The reasons for misdiagnosis are:(1)The doctors might not pay enough attention in obtaining an accurate history of foreign body aspi- ration,or the history obtained was not clear enough to estabolish the diagnosis,only the secondary pathological changes were utilized for consideration;(2)The method of X-ray examination for foreign body in the respiratory tract was not accurate enough to estabolish the diag- nosis,and the related basic knowlege is inadequate;(3)The history of foreign body aspiration was definite,but the X-ray reports were ne- gative;(4)Foreign body was in the respiratory tract as evidenced by other means,but it can not be discovered by bronchoscopy;(5) Multiple existance of foreign bodies in the respiratory tract. For the avoidance of the possibility of misdiagnosis,special re- marks to various conditions are presented.