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目的探讨减少慢性肺阻塞性疾病并发自发性气胸的误诊原因,以提高诊断率。方法从症状、体征和检查方面分析误诊原因。误诊的原因:COPD病程中反复发生肺部感染;严重肺气肿常掩盖典型的气胸体征;COPD老年患者,其痛觉反应较迟钝;病情危重无法行X线检查,或某些X线检查难以发现;某些COPD患者心电图酷似AMI;慢阻肺合并气胸临床症状、体征不典型,医务人员不认真体检、及时行X线检查。结论对COPD患者应常规作X线胸片检查,特别是疑为SP。必要时作CT检查或检查抽气,以明确诊断。
Objective To investigate the causes of misdiagnosis of patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax to improve the diagnosis rate. Methods The causes of misdiagnosis were analyzed from the aspects of symptoms, signs and examinations. Causes of misdiagnosis: recurrent lung infections in the course of COPD; severe emphysema often mask the typical signs of pneumothorax; COPD elderly patients, the painful response slow; critical illness can not be X-ray examination, or some X-ray examination is difficult to find ; Some patients with COPD ECG resembles AMI; COPD pneumothorax clinical symptoms, signs are not typical, medical staff are not serious physical examination, timely X-ray examination. Conclusion COPD patients should be routine for X-ray examination, especially suspected SP. If necessary, CT examination or check the suction to confirm the diagnosis.