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目的:探讨上肺肺炎误诊为肺结核的常见原因,提高肺炎诊断准确率。方法:根据本院2012年1月至2014年11月48例肺炎病人误诊为肺结核病例的详细病历资料和PPD皮试,T-SPOT.TB及胸部CT片分析研究。结果:被误诊的病例中,有20例属于PPD皮试强阳性,占41.67%,有26例属于T-SPOT.TB阳性,占54.17%;胸部CT病灶位于单侧肺上叶,占93.75%。结论:肺炎的诊断一般以胸部X线或胸部CT征象和临床表现的动态变化为依据,但PPD皮试强阳性或T-SPOT.TB阳性,病灶部位又位于上叶(尤其单侧肺叶),则极易导致误诊。
Objective: To investigate the common causes of pulmonary tuberculosis misdiagnosed as pulmonary tuberculosis and improve the diagnostic accuracy of pneumonia. Methods: According to the detailed medical record data, PPD skin test, T-SPOT.TB and chest CT slice analysis of 48 cases of pulmonary tuberculosis misdiagnosed as pneumonia patients from January 2012 to November 2014 in our hospital. Results: Among the misdiagnosed cases, 20 cases were strongly positive for PPD skin test, accounting for 41.67%. Twenty-six cases were T-SPOT.TB positive, accounting for 54.17%. Chest CT lesions were located in the upper lobe of unilateral lung, accounting for 93.75% . Conclusions: The diagnosis of pneumonia is usually based on the dynamic changes of chest X-ray or CT findings and clinical manifestations. However, PPD skin test is strongly positive or T-SPOT.TB positive, and the lesion is located in the upper lobe (especially the unilateral lobe) It can easily lead to misdiagnosis.