CDC对肺结核误诊误治的分析(附10例报告)

目的了解疾病控制中心(CDC)对肺结核的误诊误治情况。方法2005年来对从CDC转诊的肺结核病人的临床、胸部X线、螺旋CT、病理学等资料回顾性分析,对其误诊误治原因进行评价。结果误诊误治共10例。延误诊断药物性肝炎2例,其中1例因重症肝衰竭死亡,支气管-肺泡癌误诊为急性血行播散型肺结核3例,肺腺癌及肺鳞癌误诊为浸润型肺结核各1例,发生肺结核耐药1例,肺结核合并糖尿病、肺部感染2例。结论严格执行DOTS、及时转诊和不断提高CDC人员的诊治水平是非常必要的。

Analysis of pulmonary tuberculosis misdiagnosed or treated incorrectly by center for disease control(10-case report)

Objective To understand the misdiagnosis or wrong treatment of pulmonary tuberculosis resulted from the Center for Disease Control(CDC).Methods Retrospective analysis of clinical,chest X-ray features,spiral computated tomography or pathological data of pulmonary tuberculosis was adopted.Then the potential causes of misdiagnosis and wrong treatment were evaluated.Results Ten cases were misdiagnosed or treated incorrectly.Two tuberculous patients of hepatitis suffered from anti-tuberculosis drugs were lingeringly diagnosed,but one patient died from severe liver failure.Three cases of bronchial-alveolar cancer were diagnosed falsely as acute hematogenous disseminated pulmonary tuberculosis.One case of lung adenocarcinoma or lung aquamaocarcinoma was diagnosed falsely as secondary pulmonary tuberculosis.Drug-resistance occurred in one case.Two cases suffered simultaneously from diabetes mellitus and from lung infection.Conclusion It is of necessity to carry out strictly DOTS,make timely transferring cases and constantly improve the diagnostic and treatment levels of CDC personnel.