心源性胸腔积液6例临床病理解剖与误诊分析

Pathological anatomy and analysis of 6 cases with misdiagnosis of cardiogenic pleural effusion

目的探讨胸腔积液死亡的误诊原因,提出预防误诊的对策。方法收集我院病理科胸腔积液死亡6例尸体解剖的临床资料进行回顾性分析。结果胸腔积液死亡6例尸体解剖结果:风湿性心脏病3例,误诊为胃炎2例、慢性胆囊炎1例;慢性肺源性心脏病2例,胸部食管下端周围静脉丛血栓机化管腔闭塞伴间质性肺炎1例,均误诊为上呼吸道感染。结论本病临床早期诊断困难,症状隐蔽,需要全面检查确诊。为提高对本病的认识,对可疑患者选用全面检查手段,可降低误诊率和死亡率。

Objective To investigate the misdiagnosis causes of pleural effusion and advance countermea- sures against misdiagnosis. Methods We collected the clinical autoptic data of 6 death cases for the pleural effusion in the department of pathology of our hospital and made a retrospective analysis. Results Three cases which two were misdiagnosed as gastritis and one was misdiagnosed as chronic cholecysti because of the symptoms of bellyache and abdominal distention were rheumatic heart disease. Among the another three cases that were misdiagnosed as upper respiratory tract infection for the symptoms of cough and expectoration, two cases were chronic cot pulmonale and one was thrombus organization and obliteration of the lower esophageal peripheral veniplex in the chest and interstitial pneumonia simultaneously. Conclusion It is difficult to diagnose pleural effusion in early clinical stage. We can reduce the misdiagnosis rate and the death rate of the disease by impoving the acknowledge to the disease and adopting complete inspection for the suspected patients.