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目的 探讨川崎病误诊的原因及后果。方法 总结 79例误诊病例的特点、误诊过程及合并症的情况。结果 川崎病误诊有多方面的因素 :①对川崎病的认知缺乏及对疾病诊断缺乏纵观发病全过程的意识 ;②对与川崎病相鉴别的疾病了解不足 ,片面地抓住某种临床表现或实验室检查 ,即做出疾病诊断 ,而不再解释相继出现的全部表现 ;③询问病史及查体不够细致。川崎病误诊造成的危害 :①冠脉扩张、冠脉瘤及心脏扩大的比率较非误诊病例的比率明显增多 ;② 1个月后误诊病例的冠脉回缩程度较非误诊病例明显减低 ;③使川崎病患儿在诊治过程中承受一些不必要的检查所带来的痛苦。结论 加强对川崎病的认知 ,纵观疾病的全过程是减少该病误诊率的关键。
Objective To investigate the causes and consequences of Kawasaki disease misdiagnosis. Methods The characteristics of 79 misdiagnosed cases, misdiagnosis and complications were summarized. Results Kawasaki disease misdiagnosis of many factors: ① lack of knowledge of Kawasaki disease and lack of awareness of the disease diagnosis of the whole process of looking at the whole process of awareness; ② and Kawasaki disease differentiated diseases do not understand enough to seize a certain clinical Performance or laboratory tests, that is to make a diagnosis of the disease, and no longer explain all the performance of one after another; (3) ask the medical history and physical examination is not detailed enough. The harm caused by misdiagnosis of Kawasaki disease: ① The rate of coronary artery dilatation, coronary aneurysm and heart enlargement was significantly higher than that of non-misdiagnosed cases; ② The degree of coronary artery retraction after misdiagnosis in 1 month was significantly lower than that of non-misdiagnosed cases; ③ Kawasaki sick children in the diagnosis and treatment process to bear some unnecessary pain caused by the inspection. Conclusion To strengthen the cognition of Kawasaki disease, the key point to reduce the misdiagnosis rate of the disease is to survey the whole process of the disease.