5例成人下呼吸道异物长期误诊分析  

The analysis of long term misdiagnosis in adults with foreign bodies of the lower respiratory tract

作　　者：林晓[1] 林其昌[1] 陈公平[1] 张昕[1] 郑志萍[1] 

机构地区：[1]福建医科大学附属第一医院呼吸内科,350005

出　　处：《福建医药杂志》2004年第6期17-19,共3页Fujian Medical Journal

摘　　要：目的　探讨成人下呼吸道异物长期误诊的原因 ,提高对下呼吸道异物的认识 ,从而能及时诊断和给予有效的治疗。方法　回顾分析了近两年我科收治的误诊达 1～ 3年的 5例下呼吸道异物病人的临床表现、诊断与治疗情况。结果　只有 2例入院时提供了可疑的异物吸入史 ,但未引起足够的重视。 5例病人全部误诊为呼吸系统常见疾病 ,异物滞留气管、支气管的时间为 1～ 3年 ,经纤维支气管镜或电子气管镜取出 4例 ,1例因为异物为肉芽组织包绕 ,嵌顿管腔中 ,无法取出异物而手术治疗。结论　对异物吸入史不明确的患者 ,因临床症状不典型 ,容易被原来的慢性疾病所掩盖或误诊为其他引起慢性咳嗽的疾病 ,误诊率高。详细询问异物吸入史和及时行纤维支气管镜检查是防止成人下呼吸道异物长期误诊、误治的主要措施。Objective To explore long term misdiagnosis causes of adults with foreign bodies of the lower respiratory tract,in order to improve understanding of the disease,reduce misdiagnosis and prevent incorrect treatment.Method We analyzed retrospectively clinical manifestations,diagnosis and treatment of 5 adult patients with foreign bodies in their lower respiratory tract,who were misdiagnosed for 1 to 3 years.Result The clinical presentations of the disease lacked of specifiness.It was very easy to be misdiagnosed as other common respiratory diseases if doctors and patients ignored choking history of foreign body aspiration.The foreign bodies were kept in the lower respiratory tract for 1 to 3 years.The foreign bodies in four patients's lower respiratory tract were taken out by the pilers of the fiberoptic bronchoscopy.Conclusion Those who ignored the choking history of body aspiration were very easy to be misdiagnosed as other common respiratory diseases.It is main measure to prevent diagnostic errors and incorrect treatment that doctors inquire choking history and do fiberoptic bronchoscopy in time in doubtful patients with foreign bodies of the lower respiratory tract.

关 键 词：成年 下呼吸道异物 误诊 纤维支气管镜 手术治疗 慢性咳嗽 

分 类 号：R56[医药卫生—呼吸系统]