误诊为传统性脑血管疾病危险因素所致脑卒中的17例临床分析.docVIP

误诊为传统性脑血管疾病危险因素所致脑卒中的17例临床分析 　　[摘要] 近年来误诊为传统性脑血管疾病所致的脑卒中有呈上升的趋势。本研究选择浙江中医药大学附属嘉兴中医院（以下简称“我院”）神经内科2009年9月～2012年3月资料完整并跟踪调查了1年及以上的这类病例共17例进行了回顾性分析，旨在总结经验教训，减少误诊，提高诊断水平。其中5例误诊为多发性脑梗死，实为神经梅毒、多发性硬化、低血糖性偏瘫；9例误诊为高血压性脑出血，实为肺癌脑转移、脑静脉血栓；3例误诊为蛛网膜下腔出血，实为成人烟雾病。因此可知，肿瘤、血管炎、中枢脱髓鞘疾病、脑静脉疾病、脑血管畸形和低血糖是近年来我院6种易误诊的脑卒中，值得临床重视。 　　[关键词] 脑卒中；诊断；误诊 　　[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-7210（2014）04（a）-0135-04 　　Mistaken for traditional risk factors for cerebrovascular disease caused by clinical analysis of 17 cases of the stroke 　　WANG Leping ZHANG Feng ZHU Jianhong 　　Department of Neurology Internal， Jiaxing Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine University， Zhejiang Province， Jiaxing 314000， China 　　[Abstract] In recent years， misdiagnosed as raditional cerebral vascular disease caused by stroke has an upward trend. 17 cases in Neurology Internal of Jiaxing Chinese Medical Hospital Affiliated to Zhejiang Chinese Medicine University （our hospital for short） from September 2009 to March 2012 with complete data and follow-up survey of more than a year of such cases and a total of were retrospectively analyzed for this article， it is aims to summarize the lessons learned， reduce misdiagnosis and improve diagnosis. Among these 5 cases misdiagnosed as multiple cerebral infarction actually neurosyphilis， multiple sclerosis， paralysis hypoglycemia； 9 cases misdiagnosed as hypertensive intracerebral hemorrhage. In fact， lung cancer brain metastases， cerebral venous thrombosis； 3 cases misdiagnosed as subarachnoid under hemorrhage， real adult moyamoya disease， which showed that： tumors， vascular inflammation， central demyelinating disease， cerebral venous disease， cerebral vascular malformations and low blood sugar is often misdiagnosed in recent years in our hospital six kinds of stroke with worthy of attention. 　　[Key words] Stroke； Diagnosis； Misdiagnosis 　　近年来，一方面随着传统性脑血管疾病危险因素的有效控制，其所引发的卒中明显减少；另一方面医学交流的日益加深，医疗设备投资力度的加大，对疑难疾病的诊断能力也不断地提高，而误诊为传统脑血管疾病危险因素所致卒