摘要
目的探讨胃食管反流病(gastroesophageal reflux disease,GERD)的临床特点、诊断方法和误诊原因,以提高临床医师对本病的认识。方法回顾性分析我院2014年5月—2015年5月33例误诊病例资料。结果本组主要症状为食管外症状:咳嗽15例,胸痛8例,咽部不适6例,仅4例以典型食管内反流症状为主诉。先后在外院及本院误诊为支气管炎11例(33.33%),慢性咽喉炎7例(21.21%),冠心病心绞痛6例(18.18%),焦虑症4例(12.12%),支气管哮喘2例(6.06%),食管癌、围绝经期综合征及复发性口腔溃疡各1例(3.03%)。29例经纤维胃镜检查确诊,4例经质子泵抑制剂(PPI)诊断性治疗确诊。确诊后均经足疗程PPI治疗痊愈。结论 GERD症状复杂多样且无特异性,易误诊;临床医师应熟悉GERD食管外表现,提高本病诊断及鉴别诊断能力。
Objective To investigate the clinical characteristics,diagnostic method and misdiagnosis cause of gastroesophageal reflux disease in order to raise awareness of the disease. Methods Analysis of 33 cases of gastroesophageal reflux disease in our hospital during May 2014 and May 2015 was conducted and the relevant literature was reviewed. Results The main symptoms were extraesophageal symptoms： cough in 15 cases,8 cases of chest pain,throat irritation in 6 cases,only 4 cases with typical symptoms of esophageal reflux. 33 cases were misdiagnosed in other hospitals and other departments of our hospital. 11 cases（ 33. 33%） were misdiagnosed as bronchitis,7 cases（ 21. 21%） were misdiagnosed as chronic sore throat,6 cases（ 18. 18%） were misdiagnosed as coronary heart disease and angina pectoris,and 4 cases（ 12. 12%） were misdiagnosed as anxiety,2 cases（ 6. 06%） were misdiagnosed as bronchial asthma,1 case（ 3. 03%） was misdiagnosed as esophageal cancer,and 1 case as menopausal syndrome and recurrent oral ulcer. 29 cases were confirmed by endoscopy and 4cases were confirmed by proton pump inhibitor（ PPI）. After the diagnosis,all the patients were cured following adequate treatment of PPI treatment. Conclusion GERD symptoms are complicated without specificity,therefore it can be easily misdiagnosed. Physicians of department of respiration,department of ENT and cardiovascular department should be familiar with the clinical symptoms of gastroesophageal reflux disease,so as to improve the diagnostic and differential diagnostic capability of the disease.
出处
《临床误诊误治》
2016年第4期26-28,共3页
Clinical Misdiagnosis & Mistherapy
关键词
胃食管反流病
误诊
支气管炎
心绞痛
Gastroesophageal reflux
Misdiagnosis
Bronchitis
Angina pectoris
