论文部分内容阅读
目的:分析下肺叶结核的临床、X线表现及误诊原因,提高对本病的正确认识,减少误诊误治。方法:通过对经证实的下肺结核的X线胸片、CT及相关临床症状和体征进行分析,探讨其影像及临床表现特点。结果:本组下肺叶结核28例曾有13例误诊,其误诊率高达46.4%。结论:下叶肺结核的主要误诊原因:下叶肺结核缺乏特征X线的表现;对本病的临床特点不熟悉,过分依赖影像学报告或过分相信权威,单凭X线或一些临床表现而造成诊断错误。掌握下肺叶结核的X线表现和临床特点,提高对本病的重识,详实的病史采集,短时间内反复多次快速痰培养以及随访复查是减少或避免误诊的关键。
OBJECTIVE: To analyze the clinical manifestations, X-ray findings and causes of misdiagnosis of pulmonary tuberculosis, to improve the correct understanding of the disease and to reduce the misdiagnosis and mistreatment. Methods: The clinical manifestations and features of X-ray, CT and related clinical symptoms and signs of confirmed pulmonary tuberculosis were analyzed. Results: Thirteen patients were misdiagnosed as 28 cases of tuberculosis of the lower lobe, with a misdiagnosis rate as high as 46.4%. Conclusions: The main causes of misdiagnosis of lower lobar pulmonary tuberculosis are the lack of characteristic X-ray manifestations of lower lung tuberculosis, unfamiliarity with the clinical features of the disease, over-reliance on imaging reports or over-trust of authority, diagnosis alone on X-rays or some clinical manifestations error. Grasp the X-ray manifestations and clinical features of pulmonary tuberculosis, improve the understanding of the disease, detailed medical history collection, rapid repeated sputum culture in a short time and follow-up review is the key to reduce or avoid misdiagnosis.