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由于心包不是生命器官,心包疾病在临床上不易被察觉,常造成诊断延误或漏诊。我院自1983年1月至1986年12月,共收治急性心包炎13例,有10例发生误漏诊,误漏诊率达77%。为吸取教训,本文就此结合学习有关文献,进行分析讨论。临床资料10例中男4例,女6例,年龄21～68岁,病程最短12天,最长5个月,平均42天。全部病例均经心电图、胸片、超声心动图检查确诊,7例作心包穿刺。化脓性3例(2例由败血症引起),非特异性2例,癌性2例(肺癌转移),结核性1例,狼疮性2例。误诊为急性胆囊炎2例,肝脓肿1例,冠心病2例,风湿性心脏病1例,心肌病1例。漏诊3例。
As the pericardium is not a vital organ, pericardial diseases are not easily noticeable in clinic and often result in delayed diagnosis or missed diagnosis. Our hospital from January 1983 to December 1986, a total of 13 cases of acute pericarditis, 10 cases of missed diagnosis, misdiagnosis rate of 77%. In order to learn lessons, this article combines the study of relevant literature, analysis and discussion. Clinical data of 10 cases, 4 males and 6 females, aged 21 to 68 years, the shortest duration of 12 days, up to 5 months, an average of 42 days. All cases were confirmed by electrocardiogram, chest X-ray and echocardiography, and 7 cases were pericardiocentesis. Suppurative in 3 cases (2 cases caused by sepsis), non-specific in 2 cases, 2 cases of cancer (lung cancer metastasis), tuberculosis in 1 case, 2 cases of lupus. Misdiagnosed as acute cholecystitis in 2 cases, 1 case of liver abscess, coronary heart disease in 2 cases, rheumatic heart disease in 1 case, cardiomyopathy in 1 case. Misdiagnosis in 3 cases.