儿童支气管哮喘误诊的新特点及鉴别诊断探讨

New characteristic of misdiagnosis and approach of differential diagnosis in childhood bronchial asthma

目的探讨儿童支气管哮喘(简称哮喘)的误诊现状及鉴别诊断新特点。方法回顾性分析作者所在单位1998年11月至2008年10月收治外院转来"哮喘"患儿共810例的最后确诊情况。结果810例中误诊105例(12.96%)。被误诊为哮喘的疾病达19种。其中Tourette综合征和心因性咳嗽共50例(47.62%),均见于5岁以上的大龄患儿;而诊断为大、中气管阻塞性疾病32例(30.48%)均为5岁以下小龄患儿。结论儿童哮喘的误诊发生率仍较高,常见的大、中气管阻塞性疾病除外,大龄儿童的Tourette综合征、心因性咳嗽被误诊的情况值得重视。

Objective To approach the status of misdiagnosis and the new characteristic of differential diagnosis in childhood bronchial asthma（asthma）. Methods Retrospective analyze the status of the final diagnosis of 810 children were diagnosed as asthma by the other hospital from November, 1998 to October, 2008. Results 105 of 810 cases were misdiagnosed （12.96%）. 19 kinds diseases were misdiagnosed as asthma. 50 cases were misdiagnosed as Tourette syndrome and psychic coughing （47.62 % ）, all children are more than 5 years old; 32 cases were misdiagnosed as obstructive disease of large-middle trachea,all children are under 5 years old. Conclusions High-incidence of misdiagnosis in childhood asthma remains exist. Besides the obstructive disease of large-middle trachea frequently, the status of misdiagnosis in Tourette syndrome in older children and psychic coughing deserve to think much of.