以鼻后滴流为主要症状的变应性鼻炎的误诊分析

Misdiagnosis of allergic rhinitis patients with postnasal drip

目的探讨具有鼻后滴流症状的变应性鼻炎患者的临床表现特点及容易误诊的原因。方法分析3例分别被诊断为慢性鼻窦炎、感冒后咳嗽综合征、慢性鼻炎的以鼻后滴流为主要症状的变应性鼻炎患者的诊疗经过,分析症状的发生机制和剖析误诊原因。结果按照目前推荐的变应性鼻炎治疗推荐原则,经抗变应性鼻炎的治疗,患者症状缓解。临床治愈。结论误诊原因:①以非变应性鼻炎症状为主诉;②鼻塞、鼻痒、喷嚏、清涕等症状程度轻;③其他症状,如鼻后滴流引发的刺激性咳嗽、咽部异物感、鼻塞等症状较重;④有变应性鼻炎症状前有明显的鼻窦炎、上呼吸道染等症状,掩盖变应性鼻炎本身的症状。因此,对于有鼻后滴流症状的患者,应考虑有变应性鼻炎的可能。如果怀疑变应性鼻炎,可以考虑试验性治疗。

OBJECTIVE To investigate the clinical manifestation and the reasons of misdiagnosis of allergic rhinitis patients with postnasal drip. METHODS The clinical data of 3 patients with allergic rhinitis who had the symptom of postnasal dr ip and were mi sdiagnosed were s tudied. RESULTS The three patients to be misdiagnosed as chronic sinusitis treated by antibiotics drugs, post cold cough syndrome without any treatment, and chronic rhinitis treated with partial inferior turbinectomy. The 3 patients were diagnosed allergic rhinitis and cured with budesonide nasal spray. CONCLUSION The reasons of misdiagnosis are listed as follows. 1. The clinic doctors don＇t listen to the patient＇s complaint comprehensively and get incorrect information. 2. The symptoms of allergic rhinitis are not typical. 3. Postnasal drip is the main complaint and cause irritable cough, pharyngeal itching, globus. 4. The symptoms of allergic rhinitis are covered by other simultaneous diseases.