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目的总结不典型肺结核在基层医院误诊的原因,提高对本病的认识及诊疗水平,避免或减少误诊及漏诊。方法总结30例不典型肺结核患者的临床资料,对其疾病特点、误诊及治疗情况进行回顾性总结分析。结果本组30例患者均被误诊为其他呼吸道疾患。所有患者明确诊断为肺结核后,停用抗生素、止咳药,给予正规标准化抗结核治疗,注意休息,加强营养。大部分病例经以上方法治疗后,相关症状均在1周~2周内逐渐缓解,2周~4周症状基本消失。5例患者因药物副作用严重,而减少抗结核药物种类。结论明确诊断是治疗不典型肺结核的前提,一旦诊断成立,即按结核病诊治指南规范化治疗。早发现、早诊断、早期应用抗结核药物对减轻结核菌耐药,减少不典型肺结核后遗症,减轻患者精神压力及经济负担有很大的意义。
Objective To summarize the causes of atypical pulmonary tuberculosis misdiagnosis in primary hospitals and improve the level of knowledge and diagnosis and treatment of this disease so as to avoid or reduce the misdiagnosis and missed diagnosis. Methods The clinical data of 30 patients with atypical pulmonary tuberculosis were summarized, and their characteristics, misdiagnosis and treatment were retrospectively analyzed. Results All 30 patients in this group were misdiagnosed as other respiratory diseases. All patients with a clear diagnosis of tuberculosis, disable antibiotics, cough medicine, given formal standardized anti-TB treatment, pay attention to rest, to enhance nutrition. Most cases after the above treatment, the relevant symptoms were gradually alleviated within 1 week ~ 2 weeks, 2 weeks to 4 weeks the symptoms disappeared. 5 patients due to serious side effects of drugs, and reduce the type of anti-TB drugs. Conclusions A clear diagnosis is the prerequisite for the treatment of atypical pulmonary tuberculosis. Once the diagnosis is established, it is standardized according to the guidelines for the diagnosis and treatment of tuberculosis. Early detection, early diagnosis and early use of anti-TB drugs to reduce drug-resistant TB, reduce atypical pulmonary tuberculosis sequelae, reduce stress and financial burden on patients of great significance.