慢性阻塞性肺疾病合并局限性气胸46例误诊分析

Misdiagnosis of 46 Cases of Chronic Obstructive Pulmonary Disease Complicated with Localized Pneumothorax

目的对该院收治的慢性阻塞性肺疾病合并局限性气胸患者的误诊情况进行分析,将我院对于该病的诊断能力进行提高,提高诊断准确率,从而改善患者的生活质量。方法该院在2013年3月—2018年3年收治的慢性阻塞性肺疾病合并自发性气胸患者184例,其中有46例合并局限性气胸患者被误诊,本次研究,对46例被误诊的患者的一般临床资料进行研究,对误诊原因展开分析,从而将临床误诊率进行降低,从而提高患者的治疗效果,改善患者的生活质量。结果误诊患者中,有23例患者别诊断为慢性阻塞性肺疾病加重情况,有8例患者被诊断为肺栓塞情况,有5例患者被诊断为心源性哮喘情况,有4例患者被诊断为心绞痛情况,有3例患者被诊断为慢性肺源性心脏病失代偿期,有3例患者被诊断为肺性脑病情况,治疗方法:在46例患者通过胸部CT进行确诊之后,其中2例患者通过保守治疗后,病情有所改善;6例患者通过胸穿抽气治疗后,病情改善;36例患者通过胸腔闭式引流术进行治疗,病情改善;2例患者通过外科手术进行治疗,病情有所改善。结论慢性阻塞性肺疾病合并自发性气胸情况是常见的疾病,但是,也有一定的概率发生局限性气胸情况,所以临床中对慢性阻塞性肺疾病患者进行诊断的时候,需要对患者的病情进行仔细诊断,防止出现误诊情况,提高诊断准确率,对患者的生活质量提供有效保障。

Objective To analyze the misdiagnosis of patients with chronic obstructive pulmonary disease and localized pneumothorax admitted to our hospital, and to improve the diagnostic ability of the disease in our hospital, the diagnostic accuracy, and the quality of life of patients. Methods A total of 184 patients with chronic obstructive pulmonary disease and spontaneous pneumothorax admitted to our hospital from March 2013 to March 2018, among which 46 patients with localized pneumothorax were misdiagnosed. In the study, the author studied the general clinical data of 46 patients who were misdiagnosed, and analyzed the causes of misdiagnosis, thereby reducing the clinical misdiagnosis rate, improving the patient's treatment effect and their quality of life. Results Of the misdiagnosed patients, 23 patients were diagnosed with exacerbations of chronic obstructive pulmonary disease, 8 patients were diagnosed with pulmonary embolism, 5 patients were diagnosed with cardiogenic asthma, 4 patients were diagnosed with angina pectoris, 3 patients were diagnosed with decompensated chronic pulmonary heart disease, and 3 patients were diagnosed with pulmonary encephalopathy. Treatment: After 46 patients were diagnosed by chest CT, the condition of two patients was improved after treatment by conservative treatment, the condition of 6 patients was improved after thoracic ventilation, the condition of 36 patients was improved by closed thoracic drainage, and the condition of 2 patients was improved by surgery. Conclusion Chronic obstructive pulmonary disease with spontaneous pneumothorax is a common disease, but there is also a certain probability of localized pneumothorax. Therefore, when the diagnosis of patients with chronic obstructive pulmonary disease is performed in the clinic, the patient's condition needs to be performed. Careful diagnosis is needed to prevent misdiagnosis, improve diagnostic accuracy, and provide effective protection for patients' quality of life.