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目的回顾总结我院误诊的非典型蛛网膜下腔出血者18例。方法对误诊类型、误诊原因及防范措施进行分析。结果病人入院后误诊为上呼吸道感染的3例;酒精过量2例,椎基底动脉供血不足1例,偏头痛3例,高血压性头痛3例,病毒性脑炎1例,眩晕症3例,癫痫2例。最长误诊时间4天,最短1天。结论对临床资料要全面分析而不只拘泥于现象,对不明原因突发眩晕、意识障碍、精神改变的患者,即使无头痛、呕吐和脑膜刺激征或仅有头痛、呕吐等一项症状时不要轻易放弃SAH的诊断。
Objective To review 18 cases of atypical subarachnoid hemorrhage misdiagnosed in our hospital. Methods Misdiagnosis types, causes of misdiagnosis and preventive measures were analyzed. Results The patients were misdiagnosed as upper respiratory tract infection after admission. There were 2 cases of alcohol overdose, 1 case of vertebrobasilar insufficiency, 3 cases of migraine, 3 cases of hypertensive headache, 1 case of viral encephalitis, 3 cases of vertigo, 2 cases of epilepsy. The longest misdiagnosis time 4 days, the shortest 1 day. Conclusion The clinical data should be comprehensively analyzed and not limited to the phenomenon. Patients who have unexplained sudden dizziness, disturbance of consciousness, or mental changes should not be easily exposed to symptoms such as headache, vomiting and meningeal irritation or only headache and vomiting Abandon the diagnosis of SAH.