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目的探讨慢阻肺急性加重期(AECOPD)并发纵隔气肿的发病机制、诊断和治疗方法。方法对9例AECOPD并发纵隔气肿患者的发病诱因、临床表现、影像学检查、漏诊误诊情况、诊断治疗及预后进行回顾性分析。结果 9例患者中,经治疗7例治愈,2例因误诊导致心肺功能衰竭、感染难以控制等严重并发症而死亡。9例患者中5例误诊,1例漏诊。结论 AECOPD并发纵隔气肿临床表现被原发病掩盖,易造成误诊或漏诊,尽早进行CT等检查,可及时确诊,提高疗效,降低病死率。
Objective To investigate the pathogenesis, diagnosis and treatment of mediastinal emphysema complicated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Nine patients with AECOPD complicated with mediastinal emphysema were analyzed retrospectively on the causes, clinical manifestations, imaging findings, misdiagnosis, diagnosis, treatment and prognosis. Results Of the 9 patients, 7 were cured after treatment, 2 died of heart failure due to misdiagnosis leading to serious complications such as uncontrollable infection. Five of the nine patients were misdiagnosed and one missed diagnosis. Conclusions The clinical manifestations of AECOPD complicated with mediastinal emphysema are obscured by the primary disease. Misdiagnosis and misdiagnosis of AECOPD complicated with emphysema can easily lead to early diagnosis of CT and other diseases.