隐源性机化性肺炎误诊为社区获得性肺炎21例临床探讨  

Analysis of 21 Cases of Cryptogenic Organizing Pneumonia Misdiagnosed as Community Acquired Pneumonia

作　　者：洪瑞兰[1] 郑玲 兰国翠[1] HONG Ruilan;ZHENG Ling;LAN Guocui(Department of Pulmonary Diseases,The First Afiliated Hospital of Xiamen University,Xiamen Fujian 361022,China)

机构地区：[1]厦门大学附属第一医院肺科,福建厦门361022

出　　处：《中国卫生标准管理》2018年第23期68-71,共4页China Health Standard Management

摘　　要：目的探讨21例被误诊为社区获得性肺炎(community acquired pneumonia,CAP)的隐源性机化性肺炎(cryptogenic organizing pneumonia,COP)的临床特征,避免误诊。方法对我院收治的21例误诊为社区获得性肺炎的隐源性机化性肺炎的临床资料进行回顾性分析。结果 21例患者均有类似肺炎的症状、体征,肺功能显示限制性通气功能障碍(15例),胸CT以实变、磨玻璃状及占位性病灶为主。7例经支气管镜肺活检,14例经皮肺活检,病理明确诊断。所有患者确诊后均予糖皮质激素治疗,均有效。结论 COP的临床表现缺乏特异性,极易误诊,应及早行病理诊断,经支气管镜肺活检是简单、易行的确诊手段,COP对糖皮质激素效果好。Objective To investigate the clinical features of 21 cases of COP misdiagnosed as community-acquired pneumonia.Methods The clinical data of 21 cases of COP misdiagnosed as community acquired pneumonia(CAP)were retrospectively analyzed.Results 21 patients had similar symptoms and signs with pneumonia.15 cases had restrictive ventilatory dysfunction.The main features of chest computed tomographyc(CT)were patchy consolidation,ground-glass opacification and space-occupying lesions.7 patients were performed with transbronchial lung biopsy,and 14 patients were performed with percutaneous lung biopsy.All patients were treated with corticosteroids after diagnosis,and got good effect.Conclusion The clinical manifestations of COP are lack of specificity and are easily misdiagnosed.Pathological diagnosis should be performed as early as possible.Transbronchial lung biopsy is a simple and easy method diagnostic.Corticosteroids is effective for COP.

关 键 词：隐源性机化性肺炎 肺炎 误诊 临床特点 肺组织活检 支气管镜检查 

分 类 号：R563[医药卫生—呼吸系统]