目的:了解结节病首发症状与首诊科室的情况,以提高早期诊断率,减少误诊和漏诊.方法:回顾性分析2002年至2017年,结节病患者66例的临床资料,分析总结患者的首发症状、首诊科室以及疾病特点.结果:66例患者中,首发临床表现主要为咳嗽、胸闷及浅表淋巴结肿大,出现呼吸道症状者占72.7％.首次就诊科室中以呼吸科(43.9％)和胸外科(33.3％)居多.全组共误诊22例,误诊率33.3％.浅表病灶穿刺活检、纵隔镜活检以及胸腔镜活检较气管镜检查阳性率高.结论:结节病临床表现多种多样,缺乏特异性,各科医生应提高认识.其多以呼吸道症状表现较多,应及时行影像学、气管镜或胸腔镜检查,取组织病理确定诊断,以降低漏诊率和误诊率.%Objective:To investigate the primary symptom and the first visiting department of sarcoidosis,so as to improve diagnostic accuracy.Methods:Clinical materials from 66 patients with biopsy-proven sarcoidosis since 2002 to 2017 were analyzed retrospectively.The primary symptom,the first visiting department and the characteristics of the disease were summarized.Results:Of 66 cases,primary symptoms included cough,chest tightness and superficial lymphadenopathy,respiratory symptoms were present in 72.7％.Department of respiratory medicine and thoracic surgery were most common department for the first visiting present in 43.9％ and 3.3％.Misdiagnosed occurred in 22 cases.Lymph node or subcutaneous nodule biopsy,mediastinoscopy and thoracoscopy would receive higher positive rate than bronchoscopy.Conclusion:With a variety of clinical manifestations,lack of specificity,clinicians should raise the awareness of the disease.The diagnosis should be confirmed through a combination of the history,symptoms,imaging and pathological findings.
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