摘要
目的分析肺尘埃沉着病误诊为粟粒性肺结核的原因,总结肺尘埃沉着病误诊的经验教训。方法收集曾被诊断为粟粒性肺结核的48例肺尘埃沉着病患者的临床资料,对其肺尘埃沉着病类型、分期、职业接触史、初次就诊原因、首诊医疗机构、临床表现、胸部X线特征、抗结核治疗情况、误诊时间和误诊原因进行分析。结果所有病例误诊均发生在非职业病防治机构;符合肺尘埃沉着病Ⅰ期24例,Ⅱ期24例;均有长期生产性粉尘接触史;X线均表现为双肺野弥漫性小结节阴影,动态观察无变化;均进行过抗结核治疗;无一例有发热、咯血症状。结论掌握肺尘埃沉着病及粟粒性肺结核各自胸部X线特点,结合职业史、胸部X线动态变化以及有无反复发热、咯血等结核中毒症,可基本避免误诊。
Objective To analyze the cause of the pneumoconiosis misdiagnosed as miliary tuberculosis,and to sum up the experience of pneumoconiosis misdiagnosis. Methods Data of 48 pneumoconiosis patients who misdiagnosed as mil- iary tuberculosis were selected.The pneumoconiosis type,periodization,history of occupational exposure,the first time care reason,first contact health sectors,clinical features,chest X-ray features,anti-tuberculosis treatment situation,misdi- agnosis time and misdiagnosis reason were analyzed. Results All cases of misdiagnosis had been found in the non-oc- cupational disease prevention and control institutions;24 cases complied with pneumoconiosis I period and 24 cases complied with II period;all cases had long time productive dust exposure history;X-rays were characterized by double lung diffuse nodules field and no dynamic changes were observed;all patients were conducted with anti-tuberculosis treatment;any had fever hemoptysis symptoms. Conclusion Grasped the each chest X-ray features of pneumoconiosis and miliary tuberculosis and combined with occupational history,chest X-ray dynamic changes and whether presence tuberculosis poisoning symptoms liked fever hemoptysis repeatedly or not can be basic to avoid misdiagnosis.
出处
《中国当代医药》
2015年第31期171-173,共3页
China Modern Medicine
基金
国家临床重点专科建设项目(WY2011873)
广东省深圳市科技研发资金项目(CXB201111250112A)
