关键词: 结核, 肺/诊断, 误诊

Abstract: Objective To analyze the potential reasons for delayed diagnosis of pulmonary tuberculosis. Methods Consecutive pulmonary tuberculosis cases with delayed diagnosis were  collected from 2006 to 2009 in department of tuberculosis, Henan hospital of infectious disease. Results Forty five males and 38 females were included in this study, age ranged from 16 to 87 years old, and the median age was 46 years old. Thirtyfive cases were delayed to visit to hospitals, and 48 cases were delayed diagnosis. Average delayed time for 60 tuberculosis patients aged less than 60 years old were 2.43 months, and was 4.13 months in 23 tuberculosis case aged more than 60 years old with  significant difference(t=2.13, P=0.036).The average delayed time was 3.59 months for 35 tuberculosis cases (42.17%) who were delayed to see a doctor; and 2.40 months for 48 tuberculosis cases (57.83%) who were delayed to be diagnosed which showed no significant difference between two groups (t=1.63, P=0.145).Among 48 delayed to be diagnosed subjects, 11 cases (22.92%) were misdiagnosed as upper respiratory tract infection, 9 cases (18.75%) as pneumonia, and 4 cases (8.33%) as obsolete pulmonary tuberculosis. Fortyone of 48 delayed to be diagnosed tuberculosis patients (85.42%) firstly saw a doctor in non-tuberculosis hospitals, 17 of 41 cases (35.42%) firstly went to private clinics and community hospitals. Twenty-three delayed diagnosed cases (47.92%) were not given an X-ray examination befor diagnosed. Meanwhile, 29 patients (60.42%) did not receive PPD test, and 33 tuberculosis cases (68.75%) were not tested for sputum smear. Conclusion Misdiagnosis may be the main reason for delayed diagnosis, and delay of visiting a doctor should not be disregarded.

Key words: Tuberculosis,pulmonary/diagnosis, Diagnostic errors