42例COPD合并自发性气胸误诊临床分析

Clinical Analysis of 42 Cases of Misdiagnosis in COPD with Spontaneous Pneumothorax

目的:观察COPD合并自发性气胸患者的临床特点,分析其误诊原因及其改进对策。方法:选择本院2006年3月至2011年3月期间确诊为COPD合并自发性气胸的42例误诊患者的临床资料进行回顾性分析。结果:本组42例患者的误诊原因分别为习惯性思维、肺气肿掩盖气胸体征,老年性痛觉下降、合并冠心病、问诊信息不准确。误诊病种包括AECOPD、急性左心衰竭、急性哮喘发作及肺性脑病。结论:COPD患者出现病情变化时,应仔细体检,详细问诊,常规行胸部X线检查,以减少COPD合并自发性气胸的误诊例数。

Objective： To observe the clinical characteristics of COPD complicated with therapeutic pneumothorax and analyze the causes of misdiagnosis and improve methods. Method： 42 cases of misdiag nosed COPD complicated with therapeutic pneumothorax from Mar. 2006 to Mar. 2007 in our hospital were selected and their clinical documents were reviewed. Result： The causes of misdiagnosis were respectively habitual diagnosis, typical signs concealed by emphysema, senile pain sense loss, complication with coro-nary heart disease and unsuccessful inquiry. The cases were misdiagnosed as AECOPD, acute left heart fail-ure, acute asthmatic attacks and pulmonary encephalopathy. Conclusion： As soon as the COPD patients de-velop new manifestations, careful physical examination, inquiry and chest X-ray test is required to decrease the misdiagnosis.