小儿气管、支气管异物误诊原因分析

Analysis of Misdiagnosis of Foreign Bodies in Trachea and Bronchi of Children

目的探讨小儿气管、支气管异物的误诊原因。方法对38例小儿气管、支气管异物误诊病例进行分析,讨论其误诊原因及防范措施。结果38例中,男25例,女13例,男∶女=1.9∶1。3岁以内者34例(89.5%)。误诊病种主要为肺炎16例(42.1%)及气管、支气管炎13例(34.2%),其次为肺气肿5例(13.2%),胸膜炎2例(5.3%),肺脓肿1例(2.6%),食管异物1例(2.6%)。误诊时间3d～1年,平均17d。异物种类且多为植物性异物33例(86.8%),误诊率为25.9%。结论该病误诊的主要原因有:医生临床经验不足,未能明确异物吸入史或被忽视;医师只重视并发症,忽视原发病而误入别科诊治;X线检查未密切结合临床综合分析。因此,应提高对本病的认识,及早正确诊断和治疗。

Objective To detect the reason of misdiagnosis of foreign bodies in trachea and bronchi of children. Methods 38 cases with foreign bodies in child trachea and bronchi were analysed and the reason and prevention were studied. Results In 38 cases, male 25 cases, female 13 cases. 34 cases （89.5%） with three year old. were respectively misdiagnosised as： pneumonia 16 cases （42.1%） ; tracbeo bronchitis, 13 cases （34.2%） ; pulmonary emphysema, 5 cases （13.2%） ; pleurisy, 2 cases （5.3%） ; Lungabscess, 1 cases （2.6%）; foreign bodies in esophagnus,1 cases （2.6%）. Time of misdiagnosis： 3d-lyear. Most of foreign bodies was plant, 33 cases （86.8%）. Misdiagnostic accerancy was 25.9%. Conclusion There are three major reasons of misdiagnosis of foreign bodies in treachea and bronchi of children： doctors with poor clinical experience, without the medical history of foreign bodies seriously; caring about the appearance of complications, not primary disease; doctors analysed the result of the X-ray without clinical appearance. We must enhance recognition for it in order to improve the early diagnosis and treatment.