超声检查将其他肺部疾病误诊为胸腔积液原因分析

摘要

目的 探讨超声检查易误诊为胸腔积液的疾病类别及其临床特点,分析超声误诊的原因并提出防范对策.方法 对我院2006年1月-2011年10月首次超声检查误诊为胸腔积液,后经胸部CT或手术病理确诊为其他疾病的34例相关声像图资料进行分析总结.结果 本组34例经胸部CT或手术病理确诊为肺实变11例,胸膜肥厚9例,肺大泡5例,肺血管瘤5例,胸壁结核脓肿向胸腔内突4例；其中初级医师误诊18例(52.94％),中级医师误诊13例(38.24％),副主任医师误诊3例(8.82％).结论 胸腔积液病因复杂,临床医师尤其是初级医师通过二维(黑白)超声无法对疾病进行定性诊断时,应及时行彩色多普勒超声、胸部CT或胸腔穿刺等检查,以免误漏诊.%Objective To explore the classification and clinical features of pleural effusion misdiagnosed by ultrasound examination and analyze cause and countermeasures. Methods Correlative ultrasonogram data of 34 patients with pleural effusion during January 2006 and October 2011 confirmed by pectoral CT examination or surgical pathology but first misdiagnosed by ultrasound examination were analyzed and summarized. Results Among 34 patients confirmed by pectoral CT examination or pathology, there were 11 patients with lung consolidation, 9 with pachynsis pleurae, 5 with bullae, 5 with pulmonany angioma and 4 with thoracic tuberculosis abscess sticking to the chest. The misdiagnosis rate of primary physicians, intermediate physicians, associate chief physicians was 52.94% (18/34) , 38.24% (13/34) and 8.82% (3/34) respectively. Conclusion Pleural effusion can be developed from many diseases. So ultrasonic physicians, especially primary physicians should use color Doppler ultrasound, chest CT and carry out thoracentesis examinations in order to avoid missed diagnosis and misdiagnosis when the two-dimension ultrasound can not detect the disease.