小儿呼吸困难误诊漏诊临床分析

Misdiagnosis and missed diagnosis of dyspnea in children.

目的探讨误诊漏诊的小儿呼吸困难及其原因。方法回顾性分析我院儿科62例误诊漏诊呼吸困难患儿的临床资料。结果62例误诊漏诊的呼吸困难患儿中,呼吸道误吸19例,呼吸系统解剖异常14例,先天性心脏病12例,纵隔占位性疾病6例,糖尿病酮症酸中毒3例,吉兰-巴雷综合征2例,其它6例。其中单一病因(非肺炎疾患)所致呼吸困难14例,复合病因(肺炎+基础疾病)48例。因疾病表现不典型或基础疾病被肺炎掩盖而误诊漏诊。结论小儿呼吸困难误诊漏诊的主要疾病是呼吸道误吸。对那些不能单独用呼吸系统疾病合理解释的呼吸困难,应尽早做相应检查以便确诊。

Objective To explore the illnesses and causes of misdiagnosis and missed diagnosis of dyspnea in children. Methods The clinical data of 62 children with dyspnea in department of pediatrics of the first affiliated hospital of Xinxiang Medical College were analyzed retrospectively. Results These illnesses which led to dyspnea included respiratory tract aspiration（ 19 ）, anatomic anomalies of respiratory system （14）, congenital heart disease（12）, mediastinal mass（6 ）, diabetic ketoacidosis（3）, Guillain-Barre syndrome（ 2 ） and others（6）. The causes of their misdiagnosis and missed diagnosis were that their manifestations were not typical and were covered by pneumonia. Conclusion Respiratory tract aspiration is the major disease of misdiagnosis and missed diagnosis of dyspnea in children. Corresponding examinations should be done as soon as possible if dyspnea can not reasonably be explained by respiratory system disease.