咽部异物漏诊的常见部位及原因分析

Discussion the Common Misdiagnosis Position and Cause of Pharyngeal Foreign Body

目的提高咽部异物的首诊确诊率,减少漏诊率。方法对就诊2次以上仍不能确诊的51例咽部异物患者的临床资料进行回顾性分析。结果51例咽部异物误诊为咽刺(擦)伤45例(占88.24%)、急性会厌炎4例(占7.84%)、会厌脓肿2例(占3.92%)。异物位于腭舌弓与扁桃体间隙29例(占56.86%),位于会厌谷12例(占23.53%),位于扁桃体隐窝7例(占13.73%),包埋在扁桃体窝内3例(占5.88%)。其中13例(25.49%)在电子喉镜下确诊。结论患者主诉疼痛的部位与异物停留的位置可能不一致,掌握咽部异物常见的存留部位并依序检查可减少漏诊,必要时可做电子喉镜检查。

Objective To improve the accuracy of first diagnosis rate of foreign body in pharynx and and to lessen misdiagnosis and false diagnosis. Methods The clinical data of 51 pharyngeal foreign body who could not diagnosis above two times were retrospectively analyzed. Results 51 cases were located in between palatoglossal arch and tonsil, palatine tonsil crypts and epiglottic vallecula, 13 （25.49%） cases were confirmed by electronic laryngoscope. Conclusion Sometimes the pain position of chief complaint is not the same with the location of foreign body rested, ~asping the position common retention and sequence checking may reduce misdiagnosis, electronic laryngoscope could be performed if necessary.