【摘要】 目的探讨易误诊为儿童喘息性疾病的疾病的临床特点及误诊原因、防范误诊措施。方法对误诊为儿童喘息性疾病96例的临床资料进行回顾性分析。结果本组因喘息及慢性咳嗽在外院或者我院门诊误诊为喘息性支气管炎46例,毛细支气管炎35例,咳嗽变异型哮喘12例,支气管哮喘3例,发病1周～2月余收住我科,平均病程15.6 d。误诊时间2～47 d,平均11.25 d。入院后经详细询问病史、仔细体格检查及行相关医技检查,确诊为声门下狭窄15例,支气管内膜炎13例,气管和(或)支气管软化及支气管异物各12例,先天性喉喘鸣和支气管内生性狭窄各10例,气管和(或)支气管发育畸形8例,闭塞性支气管炎及气管和(或)支气管外压性狭窄各7例,会厌囊肿2例。给予相应治疗后喘息症状和体征逐渐减轻、消失。结论喘息性支气管炎、毛细支气管炎、咳嗽变异型哮喘及支气管哮喘为儿童常见喘息性疾病,但并非所有慢性咳嗽及喘息症状和体征都为以上4种疾病引发,临床应仔细鉴别诊断。当遇及类似本文患者按初诊疾病治疗效果不佳时应有目的地进一步完善相关检查,尤其是影像学检查及支气管镜检查,以减少或避免此类疾病误诊误治。更多还原

【Abstract】 Objective To explore the clinical characteristics, causes of misdiagnosis, and preventive measures for misdiagnosis of disease as asthmatic diseases in children. Methods The clinical data of 96 cases misdiagnosed as asthmatic diseases were analyzed retrospectively. Results In this group, there was misdiagnosed disease as asthmatic bronchitis(n=46), bronchiolitis(n=35), cough variant asthma(n=12) and bronchial asthma(n=3) due to wheezing and chronic cough in other hospitals or in Outpatient Department of our hospital. The average course of disease was 15.6 d, and the duration of misdiagnosis was 2-47 d, with an average of 11.25 d. After admission, these cases were examined by detailed consultation, physical examination, and relevant laboratory examinations. There were 15 cases misdiagnosed that were finally diagnosed with subglottic stenosis, 13 cases with bronchus endometritis, 12 cases with trachea and/or bronchi softening, 12 cases with bronchial foreign body, 10 cases with congenital laryngeal stridor, 10 cases with endogenous bronchial stenosis, 8 cases with trachea and/or bronchi malformations, 7 cases with obliterative bronchitis and compressed tracheal and/or bronchial stenosis and 2 cases with epiglottis cyst. After appropriate treatment, wheezing symptoms and signs were reduced or disappeared. Conclusion Asthmatic bronchitis, bronchiolitis, cough variant asthma and bronchial asthma are common asthmatic diseases in children, but not all chronic cough and asthmatic diseases can be classified as above four diseases, which should be carefully differentiated and diagnosed clinically. Given similar cases in this study, relevant examinations, especially imaging examinations and bronchoscopy, should be further improved to reduce or avoid misdiagnosis and mistreatment of such diseases when the therapeutic effect of the disease based on initial diagnosis is far fro satisfactory.更多还原