风湿性心脏病误诊因素分析(1)
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【摘要】 目的 对于风湿性心脏病误诊因素进行分析。方法 选取我院2002～2009年共收治住院慢性风湿性心脏病600例中,50例(占8.33%)出院前长期误诊。年龄均在50-70岁之间,男38例,女12例。结果 本文50例误诊资料特点为年龄均在50岁以上, 96%入院前未进行心脏B超检查,38% 入院时为快速房颤或房扑,89%入院前既有心悸,气短病史,病程最长者达10年,最短2月。58%曾因呼吸困难,肺反复感染多处诊治而漏诊。 3例首次因呼吸困难就诊。部分合并高血压病,慢性支气管炎,肺气肿,心脏形态不典型。心脏B超检查大部分二尖瓣口高度狭窄,左房明显增大。结论 风湿性心脏病误诊主要因素为患者年龄较大无风心病史;合并心房纤颤,高血压;慢支肺气肿,严重心衰;;未及时进行心脏B超检查及个别医生检查不仔细等。
【关键词】 风湿性心脏病;误诊因素;分析
【中图分类号】R541 【文献标识码】 B 【文章编号】1005-0515(2010)007-025-03
Misdiagnosis of rheumatic heart disease factors
Fang Ruixiang Tan Huaqing
Loudi Central Hospital of Hunan Loudi 417 000
Abstract: Objective: The Misdiagnosis of rheumatic heart disease factors were analyzed. Methods: From 2000 to 2009 in our hospital were treated in hospital 600 cases of chronic rheumatic heart disease, 50 cases (8.33%) prior to discharge long-term misdiagnosis. All the patients were 50-70 years old, 38 males and 12 females. Results: This article features information on 50 cases misdiagnosed as the age of 50 years of age, 100% of the time of admission did not hear the apical zone like rumbling diastolic murmur. 96% did not conduct pre-hospital cardiac B-ultrasound, 38% of the admission for the rapid atrial fibrillation or atrial flutter, 89% both before admission palpitations, shortness of breath history, the longest course of disease for 10 years and the shortest in February. 58% Zengyin dyspnea, recurrent pulmonary infection treatment and missed many. Three cases of first visits because of respiratory difficulties. Some patients with hypertension, chronic bronchitis, emphysema, heart shape is not typical. Most of B-ultrasound heart mitral valve stenosis height, left atrium increased significantly. Conclusion: The main factors of rheumatic heart disease misdiagnosed older patients without a history of rheumatic heart disease; atrial fibrillation, hypertension; chronic bronchitis emphysema, severe heart failure; cardiac diastolic murmur heard before the District; not timely B ultrasound heart examination and individual doctors are not careful so.
Key words: Rheumatic heart disease; misdiagnosis factor; Analysis
前言
风湿性心脏病简称风心病,是指由于风湿热活动,累及心脏瓣膜而造成的心脏病变。表现为二尖瓣、三尖瓣、主动脉瓣中有一个或几个瓣膜狭窄和(或)关闭不全 ......
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