ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2016, Vol. 8 ›› Issue (6): 599-601.doi: 10.3969/j.issn.1674-3865.2016.06.016

• 临床研究 • 上一篇    下一篇

儿童鼻窦炎临床误诊原因分析

王然然，肖向丽，丁锋，秦莉   

  1. 430015 武汉，武汉市红十字会医院儿科(王然然，肖向丽，秦莉)；430012 武汉，武汉市汉口医院耳鼻喉科(丁锋)
  • 出版日期:2016-12-25 发布日期:2018-11-19
  • 通讯作者: 丁锋，E-mail：98093693@163.com
  • 作者简介:王然然(1986-)，女，医师。研究方向:小儿呼吸系统疾病的诊治

Analysis of the causes of clinical misdiagnosis in children with sinusitis

WANG Ranran，XIAO Xiangli，DING Feng，QIN Li   

  1. Department of Pediatrics, the Red Cross Hospital of Wuhan, Wuhan 430015, China
  • Online:2016-12-25 Published:2018-11-19

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摘要： 目的：探讨儿童鼻窦炎的误诊原因，提高诊断与鉴别诊断的能力，以减少误诊误治。
方法：2013年1月至2015年10月武汉市红十字会医院儿科及武汉市汉口医院耳鼻喉科收治误诊为其他疾病的鼻窦炎患儿92例，分析其病例资料。
结果：92例患儿首诊均被误诊，72例(78.3%)经鼻内镜检查或电子鼻咽镜检查确诊为鼻窦炎，其中12例伴有腺样体肥大，7例伴过敏性鼻炎，9例伴分泌性中耳炎，2例伴扁桃体肥大；20例(21.7%)经鼻窦CT检查确诊为鼻窦炎。
结论：儿童鼻窦炎常因患儿检查不配合而未能全面、系统的进行检查，对病情缺乏全面的分析，即做出相应的诊断，对久治不愈的患儿也未能进一步的查找原因，从而导致误诊误治。临床医师应详细询问病史，仔细查体，完善鼻内镜或头颅CT检查，扩展诊断思路，以免误诊误治。

关键词: 鼻窦炎, 误诊, 儿童

Abstract: Objective:To explore the causes of misdiagnosis of sinusitis in children, in order to improve the ability of diagnosis and differential diagnosis and to reduce the errors.
Methods:Totally 92 cases of children with sinusitis were misdiagnosed as other diseases, who were from the Department of Pediatrics, the Red Cross Hospital of Wuhan, and the Department of Otolaryngology, Hankou Hospital of Wuhan, between January 2013 to October 2015.The cases data were analyzed.
Results:Totally 72 cases(78.3%) were confirmed as sinusitis by endoscopy or electronic nasopharyngoscope examination among which 12 cases were complicated with adenoid hypertrophy,7 cases with allergic rhinitis and 9 cases with secretory otitis media and 2 cases with tonsil hypertrophy. The remained 20 cases(21.7%) were diagnosed as sinusitis by sinus CT examination.
Conclusion：Sinusitis in children is often misdiagnosed, because of children's lack of cooperation, which Results: in a lack of comprehensive and systemic examination, and the lack of the comprehensive analysis of the condition, and the reasons of the failed treatment were not investigated, either. Clinicians should make a detailed inquiry of the medical history, carefully check the body, improve the nasal endoscopic or CT examination and expand the diagnostic thinking, so as to avoid misdiagnosis and wrong treatment.

Key words: Sinusitis, Misdiagnosis, Children