154例带状疱疹误诊原因分析

Analysis on the Cause of Misdiagnosis in 154 Cases of Patients with Herpes Zoster

目的探讨带状疱疹的临床特征及误诊原因。方法对2009年11月-2012年11月收集到的154例带状疱疹患者的临床资料进行回顾性分析。结果患者误诊时间为2～16d，平均6．8d。老年人72例，占46．9％；中青年82例，占54．1％。治疗后疼痛完全消失者101例，明显减轻者53例。发病部位在三又神经节段44例，颈神经节段47例，胸段神经32例，腰骶段神经31例。最常见的误诊疾病是三叉神经痛、肋间神经痛、青光眼、急性中耳炎。结论对于带状疱疹的诊断，应提高认识，认真进行体格检查，动态观察病情变化，掌握其临床特点，尽量避免误诊的产生。

Objective To probe into the clinical characteristics of herpes zoster and the misdiagnosis causes. Method Clinical data of 154 cases of patients with herpes zoster collected from November, 2009 to November, 2012 were retrospectively analyzed. Results The misdiagnosis time was 2~ 16 d and the average time was 6.8 d. 72 cases were elderly people, accounting for 46.9% and 82 cases were young and middle--aged ones with a percentage of 54.1%. There were 101 cases whose pains were relieved after treatment while 53 cases whose pains were significantly eased off. There were 44 cases with incidence location in the trigeminal ganglion, 47 cases in the cervical ganglion, 32 cases in the thoracic nerve and 31 cases in the lumbosacral nerve. The most common misdiagnosed diseases were trigeminal neuralgia, intercostal neuralgia, glaucoma and acute offtis media. Conclusion Understanding on diagnosis of herpes zoster shall be improved, physical examination shall be conducted, changes in pathogenetic conditions shall be observed and its clinical characteristics shall be comprehended so as to avoid misdiagnosis.