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误诊为后循环缺血患者29例临床分析
引用本文:张晓丹,刘文,洪克. 误诊为后循环缺血患者29例临床分析[J]. 现代医药卫生, 2013, 0(22): 3393-3394
作者姓名:张晓丹  刘文  洪克
作者单位:南京市大厂医院神经内科,江苏南京210035
摘    要:目的探讨临床患者被误诊为后循环缺血的原因及对策,提高对后循环缺血误诊的认识,减少误诊。方法回顾性分析2011年7月至2012年11月门诊和病房诊治的29例被误诊为后循环缺血患者的临床资料.总结分析误诊原因。结果29例被误诊为后循环缺血的患者最后确诊为脑出血3例、蛛网膜下腔出血2例、良性发作性位置性眩晕8例、梅尼埃病4例、前庭神经元炎2例、桥小脑角肿瘤3例(听神经瘤2例、脑膜瘤1例)、脑转移癌1例、脑胶质瘤1例、多发性硬化1例、急性心肌梗死1例、贫血1例、低血糖2例。结论详细了解病史并进行仔细的神经系统检查,提高对头晕,眩晕的原因认识,合理理解、运用影像学及经颅多普勒检查,可减少患者被误诊为后循环缺血。

关 键 词:椎动脉  基底动脉  缺血  误诊

Clinical analysis of 29 patients misdiagnosed as posterior circulation ischemia
Zhang Xiaodan,Liu Wen,Hong Ke. Clinical analysis of 29 patients misdiagnosed as posterior circulation ischemia[J]. JOURNAL OF MODERN MEDICINE & HEALTH, 2013, 0(22): 3393-3394
Authors:Zhang Xiaodan  Liu Wen  Hong Ke
Affiliation:(Departme of Neurology ,Nanjing Municipal Dachang Hospital ,Nanjing,Jiangsu 210035, China )
Abstract:Objective To explore the cause and countermeasure of misdiagnosis of posterior circulation ischemia(PCI) and improve the cognition of misdiagnosis of PCI and decrease the misdiagnosis. Methods Clinical data of 29 patients who were misdiagnosed as PCI were analyzed retrospectively, and the misdiagnosis reasons were summarized and analyzed. Results A- mong the 29 patients misdiagnosed as PCI, 3 cases were diagnosed as intracerebral hemorrhage, 2 cases as subarachnoid hemor- rhage, 8 cases as benign paroxysmal positional vertigo ,4 cases as meniere disease, 2 cases as vestibular neuronitis, 3 cases as cerebellopontine angle tumors (2 cases of acoustic neuroma and 1 cases of meningeoma), 1 case as brain metastasis, 1 case as brain glima, 1 case s multiple sclerosis, 1 case as acute myocardial infarction, 1 case as anaemia and 2 cases as hypoglycemia. Conclusion The detailed medical histories and neurology examines and the improvements of cognition of causes in dizziness/ vertigo, reasonable understanding, employing of tomography and transcranial doppler can decrease the misdiagnosis of PCI.
Keywords:Vertebral artery  Basilar artery  Ischemia  Diagnostic errors
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