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中国防痨杂志 ›› 2005, Vol. 27 ›› Issue (3): 168-171.

• 论著 • 上一篇    下一篇

儿童原发性肺结核误诊肺炎33例分析

张旸;   

  1. 辽宁省妇幼保健院 沈阳 110005;
  • 出版日期:2005-03-10 发布日期:2005-11-03

Primary pulmonary TB misdiagnosed as pneumonia in children:a report of 33 cases

Zhang Yang.   

  1. Maternity and Child Health Care Hospital of Liaoning Province, Shenyang 110005,China
  • Online:2005-03-10 Published:2005-11-03

摘要: 目的 分析原发性肺结核误诊肺炎原因。方法 对33例儿童原发性肺结核临床表现、X线胸片、实验室检查、PPD试验结果 综合分析、找出误诊原因。结果 全部病例皆有周身结核中毒症状,而无肺炎样高热、寒战,无气急、紫绀,无胸凹陷。X线胸片显示在肺段、肺叶片影掩盖下可见原发性肺结核征象者21例;配合高电压摄片、胸部CT,全部病例的原发性肺结核征象被确认。实验室检查、PPD试验亦提供了结核病诊断依据。结论 忽视原发性肺结核与肺炎的不同临床表现、忽略或未进一步确认原发性肺结核的X线征象,未作结核菌素试验及其他特异检查等,是造成误诊的主要原因。

关键词: 儿童, 结核,肺, 误诊, 肺炎

Abstract: Objective To study misdiagnosed causes of primary TB to pneumonia.Method To analyze the clinical features,the films of chest X-ray,the reaction of tuberculin test in 33 cases,and find the differences between pneumonia and primary TB. Results General tuberculous intoxication symptoms such as subfebrile temperature, sweating ,indigestion, emaciation occurred in the cases. There were no high fever,shaking chills,tachypnea and three depression sign of pneumonia. Chest X-ray showed consolidation in lobar and segmental distribution. But see though the consolidation to get at the X-ray sign of primary TB in 21 cases. The positive result of tuberculin test supported the diagnosis of TB. Conclusion The misdiagnosis was happened, because the different clinical features were as neglected, the signs of chest-ray on primary TB was neglected, the tuberculin testing was not performed.

Key words: Children, Pulmonary tuberculosis, Misdiagnosis, Pneumonia