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我院近10年收治慢性肺心病346例,并发肺水肿者48例。其中延误诊断者16例,误诊为肺支气管感染加重7例,支气管哮喘发作6例,呼吸衰竭加剧3例。举例分析: 1.误诊为肺、支气管感染加重。举例:男,72岁。咳嗽,咳痰10余年,突然加重伴畏寒、发热半天入院。既往有慢性支气管炎史。入院后夜间咳嗽加重,不能平卧。体温38.6℃、心率90～110次/min,律齐,两肺有湿罗音。X线胸片示两肺纹理粗乱、右下肺斑片状阴影。诊断急性支气管肺炎。予消炎、化痰止咳,疗效不显著。出现劳力性呼吸困难,夜间端坐呼吸,咳自泡沫痰,再拍胸片发现两肺纹理模糊,可见Kerley B线,最后诊断为肺水肿。
Nearly 10 years in our hospital admitted to chronic pulmonary heart disease in 346 cases, complicated by pulmonary edema in 48 cases. Among them, 16 were diagnosed as delayed, 7 were misdiagnosed as pulmonary bronchial infection, 6 were bronchial asthma and 3 were aggravated by respiratory failure. For example: 1. misdiagnosed as lung, bronchial infection aggravated. For example: male, 72 years old. Cough, expectoration more than 10 years, a sudden increase with chills, fever half a day admitted to hospital. Past history of chronic bronchitis. Cough increased at night after admission, can not lie down. Body temperature 38.6 ℃, heart rate 90 ~ 110 times / min, law Qi, both lungs have wet rales. X-ray showed coarse texture of both lungs, the lower right lung patchy shadow. Diagnosis of acute bronchial pneumonia. To anti-inflammatory, Huatanzhike, the effect is not significant. Labor difficulty breathing difficulties, sit at night breathing, cough since the foam sputum, and then chest X-ray film found that the two lungs fuzzy, visible Kerley B line, the final diagnosis of pulmonary edema.