摘要
目的通过对老年人中毒误诊的原因分析,探讨减少误诊发生的方法,避免误诊造成的不良后果.方法采用回顾方法分析本院老年中毒误诊32例患者的资料.结果32例被确诊镇静安眠药中毒8例,有机磷农药中毒8例,一氧化碳中毒5例,亚硝酸盐中毒2例,洋地黄中毒2例,毒鼠强中毒1例,降压药中毒1例,乌头碱中毒1例,华法林中毒1例,抗凝血类杀鼠剂中毒2例,毒蕈中毒1例;误诊为脑血管意外11例,急性胃肠炎5例,冠心病3例,糖尿病3例,肺部感染2例,食物中毒2例,癫痫1例,休克1例,肾出血2例,尿路感染1例,多发性神经病1例;治愈24例,后遗症3例,死亡5例.结论中毒救治强调时效性,误诊可延迟或错误治疗,加之老年人生理机能减退,多伴慢性疾病,中毒后易并发多器官功能减退,增加老年中毒患者的病死率.误诊主观原因以中毒临床表现不典型,医师思维局限,知识面窄为主,客观原因与中毒接触史隐匿或故意隐瞒相关.详细采集病史,查体认真全面,重视细节,增强责任心,提高中毒意识,科学分析是防范老年人中毒误诊的主要措施.
Objective To reduce misdiagnosis and avoid the bad consequences caused by misdiagnosis by analyzing the causes of poisoning misdiagnosis in the elderly.Method The data of 32 cases of senile poisoning misdiagnosis in The Second Affiliated Hospital of Kunming Medical University were analyzed retrospectively.Results The 32 cases were diagnosed include sleeping pill poisoning in 8 cases,organophosphorus pesticide poisoning in 8 cases,carbon monoxide poisoning in 5 cases,nitrite poisoning in 2 cases,digitalis poisoning in 2 cases,tetramine poisoning in 1 case,antihypertensive drug poisoning in 1 case,aconitine poisoning in 1 case,warfarin poisoning in 1 case,class anticoagulant rodendcide poisoning in 2 cases,toadstool poisoned in 1 case.On admission,32 cases were misdiagnosed as cerebrovascular accident in 11 cases,acute gastroenteritis in 5 cases,coronary heart disease in 3 cases,diabetes in 3 cases,pulmonary infection in 2 cases,food poisoning in 2 cases,epilepsy in 1 case,shock in 1 case,renal hemorrhage in 2 cases,urinary tract infection in 1 case,and multiple neuropathy in 1 case.24 patients were cured,3 were sequelae and 5 died.Conclusion Poisoning treatment emphasizes timeliness.Misdiagnosis can be delayed or treated incorrectly.In addition,the physiological function of the elderly is impaired,accompanied by chronic diseases.Poisoning is prone to multiple organ dysfunction,which increases the mortality of elderly patients with poisoning.The subjective causes of misdiagnosis are atypical clinical manifestations of poisoning,limited thinking of physicians and narrow knowledge.The objective causes are related to the history of hiding exposure to poisoning or deliberate concealment.Detailed collection of medical history,careful and comprehensive physical examination,attention to details,enhance the sense of responsibility,improve the awareness of poisoning,scientific analysis is the main measures to prevent the elderly from poisoning misdiagnosis.
出处
《浙江临床医学》
2019年第10期1420-1422,共3页
Zhejiang Clinical Medical Journal
关键词
老年人
中毒
误诊
原因
The elderly
Poisoning
Misdiagnosis
Cause
