17例肺支气管囊肿长期误诊肺结核原因分析

摘要/Abstract

摘要： 目的　通过对肺支气管囊肿(pulmonary bronchogenic cyst,PBC)长期误诊为肺结核的原因分析,提高对二种疾病的鉴别诊断能力。方法对17例经手术病理证实的PBC长期误诊肺结核原因进行回顾性分析。结果长期误诊肺结核的PBC患者占同期手术治疗的PBC的43.6%(17/39)。主要症状:咳嗽、咳痰、咯血、胸痛、低热和乏力。X线表现形态多样,球形病变10例,部分有卫星灶及钙化灶、空洞或溶解等,大片密度不均匀阴影5例,一侧毁损肺1例,叶间裂积液1例。所有病人均查痰结核菌阴性。正规抗结核治疗后反复咳痰、咯血、发热11例(64.7%),无效6例(35.3%)。结论误诊原因是对不典型的PBC缺乏认识。痰结核菌阴性而临床症状和X线表现与肺结核相似、经正规抗结核治疗后仍反复发作或无效的病人,应考虑到PBC。

关键词: 支气管源囊肿, 误诊, 结核,肺

Abstract: Objective To improve the ability to differentiate the two diseases through the analysis of causes for PBC being long-term misdiagnosed as pulmanory tuberculosis (TB). Methods Retrospective analysis of 17 cases which are verified through surgical pathology as PBC which bad been long-term misdiagnosed as pulmonary TB.Results PBC being long-term misdiagnosed as pulmonary TB to PBC being treated by operation the same time is 43.6%(17/39). Main symtoms: cough, sputum, hemorrhage, thoracic pain, low fever and tired. Chest X-ray shows variedly, globular of 10 cases, the part with satellite focus and calcification, cavity or melting, etc. Big uneven density flat of 5 cases, unilatery damaged lung of 1 case, interlobe fluid of 1 case. Of all patients sputum for tuberculous bacterium is negative. Sputum, hemorrhage and fever repeatly occur through regularly anti-tuberculosis treatment of 11 cases (64.7%) uneffective of 6 cases (35.5%). Conclusion Causes of misdiagnosis are the lack of knowledge about atypical PBC. PBC should be considered in patients with negative sputum for tuberculous bacterium but clinical symptoms resembling pulmonary TB and after treated by regularly anti-tuberculosis repeatly occuring or effective.

Key words: Bronchogenic cyst, Misdiagnosis, Tuberculosis,Pulmonary

孙怡芬,胡瑛,胡培安,. 17例肺支气管囊肿长期误诊肺结核原因分析[J]. 中国防痨杂志, 2003, 25(2): 80-82.

SUN Yi fen, HU Ying,HU Pei an.. Analysis of causes for 17 patients with pulmonary bronchogenic cyst (PBC) being long-term misdiagnosed as pulmonary tuberculosis (TB)[J]. Chinese Journal of Antituberculosis, 2003, 25(2): 80-82.

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17例肺支气管囊肿长期误诊肺结核原因分析

Analysis of causes for 17 patients with pulmonary bronchogenic cyst (PBC) being long-term misdiagnosed as pulmonary tuberculosis (TB)

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