气道内异物误诊并气胸1例及文献复习  

Misdiagnosis of tracheobronchial foreign body with pneumothorax：a case report and literature review

作　　者：孙照琨[1] 姜巧[1] 孙杰[1] 郭振辉[1] 俞宙[1] 

机构地区：[1]广州军区广州总医院老年重症医学科 广东省老年感染与器官功能支持重点实验室 广州市老年感染与器官功能支持重点实验室,510010

出　　处：《国际呼吸杂志》2015年第12期925-928,共4页International Journal of Respiration

摘　　要：目的：提高气道内异物诊断治疗的水平，并对误治后造成气胸的处理进行探讨。方法回顾我院收治的1例气道内异物误诊为气胸患者病历资料，并复习相关文献，探讨成人气道内异物的诊断，及误治引起气胸后的诊断、处理。结果中年男性、脑外伤术后昏迷、气管切开患者，突发呼吸困难，外院误诊为气胸，治疗无效。入我院确诊为气道内异物，异物取出后好转。结论成人气道内异物易出现误诊，支气管镜检查对诊治有重要价值。阻塞性肺不张与气胸同时存在时诊断难度增加，其处理宜及时采取措施改善通气。Objective To improve the diagnoisis and treatment of tracheobronchial foreign body and discuss the treatment of pneumothorax caused by misdiagnosis.Methods The diagnoisis of tracheobronchial foreign body and treatment of pneumothorax caused by misdiagnosis were discussed. Results One adult male patient who was coma after cerebral trauma and incision of trachea was misdiagnosised as pneumothorax and the condition was not improved after treatment.Bronchoscopy indicated bronchial foreign body.The symptoms were greatly relieved after removing the foreign body. Conclusions Bronchoscopy plays an important role in the diagnosis and treatment of tracheobronchial foreign body while misdiagnosis always happen.It is difficult to make diagnoisis when obstructive atelectasis comes with pneumothorax,the most impotant thing is to improve the ventilation.

关 键 词：气道内异物 阻塞性肺气肿 误诊 气胸 

分 类 号：R768.130.5[医药卫生—耳鼻咽喉科]