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目的 探讨婴幼儿胸腺肥大的误诊原因及鉴别诊断方法。方法 对 37例胸腺肥大患儿的临床资料进行回顾性总结和分析。结果 37例中第一诊断能确诊者 9例 ,误诊 2 8例 (75 6 8% ) ,误诊疾病有大叶性肺炎 ,纵隔肿瘤 ,肺门、纵隔淋巴结结核和先天性心脏病 ;误诊时间 1周至 3个月 [平均 (2 7 4± 38 6 )d];鉴别诊断及确诊手段主要为CT、MRI检查和“泼尼松诊断性治疗”试验。结论 婴幼儿胸腺肥大易于误诊的原因主要为临床上对其认识不足及肥大胸腺有时形态多样。详细询问病史 ,应用CT、MRI等检查可使绝大多数患儿得以确诊 ,而“泼尼松诊断性治疗”试验是一个方便经济而又十分有效的鉴别诊断方法。
Objective To investigate the misdiagnosis and differential diagnosis of thymus hypertrophy in infants and young children. Methods The clinical data of 37 cases of thymic hypertrophy were retrospectively summarized and analyzed. Results Of the 37 cases, 9 cases were diagnosed as the first diagnosis, 28 cases were misdiagnosed (75.68%), and the diseases misdiagnosed as lobar pneumonia, mediastinal tumor, hilar, mediastinal lymph node tuberculosis and congenital heart disease; Misdiagnosis time 1 Week to 3 months [mean (2 74 ± 38 6) d]. The main means of differential diagnosis and diagnosis were CT, MRI and Prednisone Diagnostic Therapy. Conclusions The causes of misdiagnosis of thymus hypertrophy in infants and young children are mainly lack of understanding in clinic and sometimes the shape and size of hypertrophic thymus. Asked in detail the history of the application of CT, MRI and other tests can make the most of the diagnosis of children, and “Prednisone Diagnostic Treatment” test is a convenient and economical and very effective differential diagnosis.