肺下野结核误诊的相关因素分析  

Correlative factors in the misdiagnosis of Pulmonary tuberculosis

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作  者:郑惠聪 

机构地区:[1]汕头市结核病防治所,广东汕头515011

出  处:《国际医药卫生导报》2008年第20期25-27,共3页International Medicine and Health Guidance News

摘  要:目的探讨肺下野结核误诊的相关因素。方法对53例在外院误诊,转本所后经反复多次涂片查痰、痰培养、纤支镜术后痰培养、病理活检、胸部CT扫描、排除其他肺部疾患后给予诊断性治疗观察追踪而诊断的肺下野结核的临床资料进行回顾性分析。结果53例患者中确诊49例,确诊率为92.5%,10例多次反复痰涂片找到抗酸杆菌;8例痰培养找到抗酸杆菌;5例纤支镜术后痰培养找到抗酸杆菌;1例纤支镜术后病理活检确诊;经皮肺活检确诊1例,9例经胸部CT扫描、PPD试验强阳性确诊;19例根据X线胸片及临床综合分析排除肺部其他病变后给予诊断性抗结核治疗观察追踪2个月确诊15例,4例病灶无变化或扩大。结论对肺下野或其他比较特殊部位的病灶,在常规检查不能确诊、高度怀疑肺结核的情况下,尽早到结防机构采取细菌学检查、病理检查、诊断性治疗等综合手段,以尽快明确诊断。Objective To discuss the correlative factors in the misdiagnosis of the Pulmonary tuberculosis on lower field of lung. Methods Retrospective analysis were performed on the diagnosis of 53 cases with suspicious tuberculosis. The final confirmed diagnosis of Pulmonary tuberculosis on lower field were achieved by microscopic examination, tubercle bacillus culture, bronchoscopy biopsy, CT scanning, and diagnostic treatments. Results 49 cases got final confirmed diagnosis in these 53 cases (R=92.5%). Among these confirmed cases, lO were confirmed by microscopic examination of sputum smears, 8 were isolated by culture of sputum, 5 were cultivated by sputum after Bronchoscopy, 1 were confirmed by biopsy of bronchoscopy, 9 were confirmed by chest CT scanning with intensive positive PPD test, 15 were confirmed finally according to chest radiograph and exclusive diagnosis in combination with the trace of 2 month long diagnostic treatments. Conclusion For those focus of infection located in the lower field of lung With the suspicious tuberculosis, when the confirmed diagnosis could not be attained by routine examination, patients should be sent to the institutes of Tuberculosis Prevention and Cure promptly for further examination and treatments

关 键 词:肺下野 结核 误诊 

分 类 号:R5[医药卫生—内科学]

 

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