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目的:分析胸壁结核误诊原因,提出对策,提高诊断的正确率。方法:对2000年1月至2015年12月误诊的胸壁结核31例进行回顾性分析。结果:误诊为乳腺癌10例,胸壁脓肿8例,胸壁肿瘤6例,肋软骨炎4例,肋间神经痛3例。结论:胸壁结核的临床表现缺乏特异性,当症状不典型时,应常规做胸部超声检查、CT检查、PPD试验和聚合酶链法检测结核菌脱氧核糖核酸,必要在超声引导下穿刺抽吸做细菌学检查,用大号活检针穿刺肿块做病理活检等辅助检查,综合分析,提高确诊率。
Objective: To analyze the causes of misdiagnosis of chest wall tuberculosis and to put forward countermeasures to improve the accuracy of diagnosis. Methods: 31 cases of chest wall tuberculosis misdiagnosed from January 2000 to December 2015 were retrospectively analyzed. Results: Misdiagnosed as breast cancer in 10 cases, chest wall abscess in 8 cases, chest wall tumor in 6 cases, costochondritis in 4 cases, intercostal neuralgia in 3 cases. Conclusions: The clinical manifestations of chest wall tuberculosis are not specific. When the symptoms are not typical, chest ultrasound, CT examination, PPD test and polymerase chain reaction should be routinely performed to detect TB DNA. It is necessary to perform aspiration and suction under the guidance of ultrasound Bacteriological examination, biopsy with large biopsy needle biopsy and other auxiliary examination, a comprehensive analysis to improve the diagnosis rate.