摘要
目的提高慢性咳嗽病因鉴别诊断能力,以减少误诊误治。方法回顾性分析2012年1月—2013年12月我院因慢性咳嗽就诊的117例临床资料。结果 117例均以慢性咳嗽为主诉,病程6~36个月。其中56例（47.86%）为明显的夜间刺激性咳嗽,33例（28.21%）为以白天为主的发作性咳嗽,16例（13.68%）为慢性刺激性干咳或咳少许黏痰,12例（10.26%）仅为干咳。多数患者伴有咽痒、胸闷、咳痰、胃灼热、胸痛、恶心,个别伴有低热。本组外院就诊2~5次,均误诊,误诊疾病：支气管炎70例（59.83%）、咽炎47例（40.17%）。就诊我院后经完善相关医技检查明确病因,其中43例（36.75%）病因为咳嗽变异性哮喘,17例（14.53%）为上气道咳嗽综合征,14例（11.97%）为嗜酸粒细胞性支气管炎,13例（11.11%）为胃食管反流病,11例（9.40%）为变应性咳嗽,8例（6.84%）为血管紧张素转换酶抑制剂相关性咳嗽,2例（1.71%）为肺癌,9例（7.69%）病因不明。结论慢性咳嗽病因复杂,易发生过度治疗。临床医师对慢性咳嗽患者应拓宽诊断思路,不应仅满足于咽炎和支气管炎的诊断,完善相关医技检查,及早明确病因,避免造成不良后果。
Objective To investigate the cause of misdiagnosis and the mistreatment of chronic cough. Methods The clinical data of 117 cases of chronic cough treated in our hospital during January 2012 and December 2013 were analyzed retrospectively.Results 117 cases complained of chronic cough and the course was 6-36 months,including 56 cases（ 47. 86%） of obvious nighttime irritating cough,33 cases（ 28. 21%） with daytime paroxysmal cough,16 cases（ 13. 68%） of chronic irritant dry cough or cough with a little sticky phlegm,12 cases（ 10. 26%） of only a dry cough. Most of the patients complained of an itchy throat,chest tightness,chest pain,nausea,heartburn,expectoration,sometimes accompanied with a low fever. This group of patients had visited other hospitals 2 to 5 times,and all were misdiagnosed,including： 70 cases（ 59. 83%） of bronchitis,47 cases（ 40. 17%） of pharyngitis. In our hospital,the patients were examined and the cause of the disease was identified,including 43 cases（ 36. 75%） of cough variant asthma,17 cases（ 14. 53%） of upper airway cough syndrome,14 cases（ 11. 97%） of eosinophil; eosinophil bronchitis,13 cases（ 11. 11%） of esophageal and gastric anti reflux disease,11 cases（ 9. 40%） of allergic cough,8 cases（ 6. 84%） of an angiotensin converting enzyme inhibitor related cough,2 cases（ 1. 71%） of lung cancer,9 cases（ 7. 69%） of unknown etiology. Conclusion The cause of chronic cough is complex,and excessive treatment is often reported. Clinicians should broaden their view of diagnosis of chronic cough,avoid attributing it to only pharyngitis and bronchitis. Relevant medical examination techniques should be improved to make early diagnosis and avoid adverse consequences.
出处
《临床误诊误治》
2015年第10期42-45,共4页
Clinical Misdiagnosis & Mistherapy
关键词
咳嗽
误诊
咽炎
支气管炎
诊断
Cough
Misdiagnosis
Pharyngitis
Bronchitis
Diagnosis
