26例低渗性昏迷误诊分析

Analysis of misdiagnosis of 26 patients with hypotonic coma

目的分析低渗性昏迷患者的诊断及治疗,提高临床工作者对该疾病的诊治水平。方法回顾性分析我院2010年1月~2013年7月误诊的26例低渗性昏迷患者的临床资料,总结误诊状况、分析误诊原因并观察治疗结果。结果 26例患者均以神志恍惚为首发症状,入院均误诊为脑梗死,经过临床查体、头颅CT以及生化检查最终确诊为低渗性昏迷,输入高渗盐水治疗,患者意识情况渐好转,电解质恢复正常。结论临床工作者应掌握低渗性昏迷患者的发病特点,针对性进行影像学以及实验室检查,减少误诊的发生。

Objective To analyze the diagnosis and treatment of patients with hypotonic coma,and improve the diagnosis and treatment level of this disease. Methods The clinical data of misdiagnosis of 26 patients with hypotonic coma from January 2010 to July 2013 in our hospital were retrospectively analyzed;the misdiagnosis data was summarized,the causes of misdiagnosis was analyzed and the treatment outcomes was observed. Results The first symptom of 26 patients were absentminded, they were misdiagnosed as cerebral infarction,but they were eventually diagnosed as hypotonic coma by clinical examination,CT and biochemical tests,and treated with Hypertonic saline, the patients gradually improved situation awareness,electrolyte restored normal. Conclusion Clinicians should understand the clinical characteristics of hypotonic coma, targeted for imaging and laboratory tests to reduce the incidence of misdiagnosis.