20篇结核病临床病理讨论系统回顾分析

Systematic review of 20 clinical pathological conference articles on tuberculosis

目的探讨结核病误诊的原因。方法手工检索近20年发表在中华结核和呼吸杂志等五种中华级杂志上的20篇有关结核病误诊的临床病理讨论(clinical pathological conference,CPC)文章,并逐一登记患者的临床特征、最后病理诊断、应吸取的教训等。结果20例结核病中急性粟粒性结核13例,占65.0%;大量使用糖皮质激素引起结核活动、播散共8例,占40.0%。结论临床医生必须高度重视结核病的诊断,以期减少结核病漏诊。

Objective To explore the causes of tuberculosis misdiagnosis. Method 20 clinical pathological conference（CPC） articles on underdiagnosis of tuberculosis published in Chinese series core journals were searched by means of manual searching. The patient＇ s characteristics, final pathological diagnosis and the lessons of under - diagnosis were recorded. Results Among 20 cases with tuberculosis, 13 （65.0%） cases with miliary tuberculosis, 8 （40.0%） cases were incured by large amount application of glucocorticoids. Conclusion Clinical doctors should have high awareness on tuberculosis in order to reduce underdiagnosis.