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1、风湿性心脏病误诊因素研究【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
2、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)007-025-03MisdiagnosisofrheumaticheartdiseasefactorsFangRuixiangTanHuaqingLoudiCen
3、tralHospitalofHunanLoudi417000Abstract:Objective:TheMisdiagnosisof8rheumaticheartdiseasefactorswereanalyzed.Methods:From2000to2009inourhospitalweretreatedinhospital600casesofchronicrheumaticheartdisease,50cases(8.33%)priortodischargelong-termmisdiagn
4、osis.Allthepatientswere50-70yearsold,38malesand12females.Results:Thisarticlefeaturesinformationon50casesmisdiagnosedastheageof50yearsofage,100%ofthetimeofadmissiondidnotheartheapicalzonelikerumblingdiastolicmurmur.96%didnotconductpre-hospitalcardiacB
5、-ultrasound,38%oftheadmissionfortherapidatrialfibrillationoratrialflutter,89%bothbeforeadmissionpalpitations,shortnessofbreathhistory,thelongestcourseofdiseasefor10yearsandtheshortestinFebruary.58%Zengyindyspnea,recurrentpulmonaryinfectiontreatmentan
6、dmissedmany.Threecasesoffirstvisitsbecauseofrespiratorydifficulties.Somepatientswithhypertension,chronicbronchitis,emphysema,heartshapeisnottypical.MostofB-ultrasoundheartmitralvalvestenosisheight,leftatriumincreased8significantly.Conclusion:Themainf
7、actorsofrheumaticheartdiseasemisdiagnosedolderpatientswithoutahistoryofrheumaticheartdisease;atrialfibrillation,hypertension;chronicbronchitisemphysema,severeheartfailure;cardiacdiastolicmurmurheardbeforetheDistrict;nottimelyBultrasoundheartexaminati
8、onandindividualdoctorsarenotcarefulso.Keywords:Rheumaticheartdisease;misdiagnosisfactor;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。患病初期常常无明显症状,后期则表现为心慌气短、乏力、咳嗽、肢体水肿、咳粉红色泡沫痰,直至心力衰竭而死亡。有的则表现为动脉栓塞以及脑梗塞而死亡[1]。本病多发于冬
