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我院1990年初～1994年底收治血行播散型肺结核(简称血播肺结核)85例,其中误诊34例,误诊率40.0%.该34例患者均由外院转入.现将误诊情况作初步分析,以吸取经验教训.1 临床资料1.1 一般资料误诊34例,其中男20例,女14例.男:女为14:1.年龄5～72岁,平均42岁.1.2 首发症状发热30例,其中6例高热.盗汗10例,咳嗽20例,咳痰14例,咯血或痰血12例,胸痛12例,胸闷、气急9例,消瘦、乏力21例.1.3 辅助检查 34例入院后均常规行3次以上痰涂片查结核菌及结核菌素试验;有14例痰菌阳性,16例结核菌素试验强阳性.1.4 X线胸片检查本组外院带来3例胸透报告,均为肺纹理增强.有6例胸片质量差,给诊断造成困难.可供诊断参考的胸片有25例,为急性、亚急性及慢性血播肺结核的各种不同期的胸片,其中14例比较典型.
In our hospital from early 1990 to the end of 1994, 85 cases of hematogenous disseminated pulmonary tuberculosis (referred to as blood borne tuberculosis) were admitted, of which 34 cases were misdiagnosed, the misdiagnosis rate was 40.0% .The 34 patients were transferred from the outer hospital.A preliminary analysis of misdiagnosis, In order to learn the lessons .1 clinical data 1.1 general information misdiagnosed 34 cases, including 20 males and 14 females.Male: female 14: 1.Age 5 to 72 years old, average 42 years.1.2 The first symptom of fever in 30 cases, of which 6 cases of fever, night sweats in 10 cases, cough in 20 cases, expectoration in 14 cases, hemoptysis or sputum in 12 cases, chest pain in 12 cases, chest tightness, shortness of breath in 9 cases, weight loss and weakness in 21 cases .1.3 auxiliary examination of 34 cases were admitted to the routine line 3 sputum smear examination of tuberculosis and tuberculin test; 14 cases of sputum positive, 16 cases of tuberculin test strongly positive .1.4 X-ray examination of the outer hospital to bring three cases of thoracic reports were Six cases had poor quality of chest radiograph, which made the diagnosis difficult.Amount of chest radiographs available for diagnosis were 25 cases, which were all kinds of chest radiographs of acute, subacute and chronic blood-borne tuberculosis, of which 14 cases More typical.