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颈动脉夹层临床误漏诊分析 被引量：1

Clinical Misdiagnosis and Missed Diagnosis Analysis of Cervical Artery Dissection
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摘要 目的探讨颈动脉夹层(cervical artery dissection,Ce AD)的诊治现状,分析临床表现不典型Ce AD的误漏诊原因及防范措施。方法对我院收治的2例曾误漏诊的临床表现不典型的Ce AD临床资料进行回顾性分析。结果本组因颈部扭伤48 h,突发左侧肢体强直、僵硬伴左眼失明3 h及突发左侧肢体力弱伴头痛6 h入院各1例,发病初期曾分别诊断为颈椎病和脑出血,1例漏诊,入我院后均经头颈螺旋CT动脉造影(CTA)检查确诊为Ce AD,分别给予抗凝、抗血小板及营养神经等治疗及仅给予营养神经治疗,均病情好转出院。结论 Ce AD临床表现复杂多变且缺乏特异性,首诊易误漏诊。加强对该病认识、仔细问诊和查体及发散诊断思维有利于提高Ce AD早期诊断率,改善患者预后。 Objective To discuss the current treatment method of cervical artery dissection （ CeAD） and to analyze the cause of misdiagnosis and missed diagnosis and preventive measures for atypical CeAD. Methods Clinical data of two pa-tients misdiagnosed and missed diagnosis with atypical CeAD were retrospectively analyzed in our hospital. Results One pa-tient suffered stiffness in the left limbs and blind in the left eye for 3 hours due to sudden neck sprain for 48 hours. The other presented with weakness in the left limbs and a headache for 6 hours. In the early stage, patients had been initially misdiag-nosed with cervical spondylosis and cervical hemorrhage respectively, and one patient missed diagnosis. Both were diagnosed with CeAD by computer tomographic angiography （ CTA） upon admission. One patient was treated with anticoagulation, anti-platelet theray and neurophic treatment. The other received only neurophic treatment. Both the patients turned for the better and were discharged. Conclusion Clinical manifestation of CeAD is complex, changeable, and lacks specificity, prone to misdiagnosis and missed diagnosis for the first visit. Improving awareness for CeAD, careful inquiry and physical examination, and divergent diagnostic thinking may contribute to increasing early diagnostic rate of CeAD and improving prognosis of CeAD patients.
作者 刘永飞 赵贵锋 王佳楠 康伟民 闫斌 刘佳 任丹丹 刘福友 侯备 姜卫剑
机构地区 第二炮兵总医院重症医学科
出处 《临床误诊误治》 2015年第11期1-4,共4页 Clinical Misdiagnosis & Mistherapy
关键词 动脉瘤 夹层 误诊 漏诊 颈椎病 脑梗死 Aneurysm,dissecting Misdiagnosis Missed diagnosis Cervical spondylosis Brain infarction
分类号 R543.4 [医药卫生—心血管疾病]
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参考文献18

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共引文献2

同被引文献23

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临床误诊误治
2015年 第11期

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