目的 :探讨肺结核漏误诊原因。方法 :对 12 6例各型肺结核在误诊时的症状、体征、胸片、CT片及误治后的病情进行分析。结果 :初次患Ⅰ、Ⅱ、Ⅲ型肺结核的病人中 38例 (30 15 % )误诊为上呼吸道感染、气管炎、慢性支气管炎 ,2 7例 (2 1 43% )误诊为肺炎、肺部感染 ,17例 (13 49% )误诊为支气管扩张 ,12例 (9 5 % )误诊为肺脓肿 ,9例 (7 14% )误诊为肺癌 ,9例合并肠结核、腹腔结核病人误诊为肠炎、痢疾、阑尾炎 ,4例误诊为颈淋巴结炎 ,其余误诊为风湿病 2例、关节炎 2例、营养不良 2例、肾结石 3例、周围性面瘫 1例。误诊时间在 2mon～ 2a多不等。结论 :肺结核发病形式多样化 ,临床表现、胸片常不典型 ,尤其是医务人员警惕性不高 ,不重视胸片、痰结核菌及其免疫学检查、纤支镜、病理学检查 ,没有综合系统的分析病情 ,是造成误诊的主要原因 Objective: To investigate the causes of missed diagnosis of pulmonary tuberculosis. Methods: The symptoms, signs, radiographs of chest radiographs, CT radiographs and post-mistreatment of 126 pulmonary tuberculosis cases of various types were analyzed. Results: Thirty-eight (30 15%) of the patients with type I, II and III pulmonary tuberculosis were misdiagnosed as upper respiratory tract infection, bronchitis and chronic bronchitis, 27 cases (2143%) were misdiagnosed as pneumonia, pulmonary infection (13 49%) were misdiagnosed as bronchiectasis, 12 cases (95%) were misdiagnosed as lung abscess, 9 cases (7 14%) were misdiagnosed as lung cancer, 9 cases were complicated by enteric tuberculosis. Patients with abdominal tuberculosis were misdiagnosed as enteritis and dysentery , Appendicitis, 4 cases misdiagnosed as cervical lymphadenitis, the other misdiagnosed as rheumatism in 2 cases, 2 cases of arthritis, malnutrition in 2 cases, 3 cases of kidney stones, peripheral facial paralysis in 1 case. Misdiagnosis time in 2mon ~ 2a many range. Conclusion: The incidence of tuberculosis is diversified, clinical manifestations, chest radiographs are often not typical, especially medical staff is not vigilant, do not attach importance to chest radiograph, sputum TB and immunological examination, bronchoscopy, pathological examination, there is no comprehensive Systematic analysis of the disease is the main reason for misdiagnosis