李红梅, 李侠, 白金, 任晓彤. 2007—2018年我国报告155例铅中毒误诊分析[J]. 职业卫生与应急救援, 2019, 37(6): 524-527. DOI: 10.16369/j.oher.issn.1007-1326.2019.06.005
引用本文: 李红梅, 李侠, 白金, 任晓彤. 2007—2018年我国报告155例铅中毒误诊分析[J]. 职业卫生与应急救援, 2019, 37(6): 524-527. DOI: 10.16369/j.oher.issn.1007-1326.2019.06.005
shu
LI Hongmei, LI Xia, BAI Jin, REN Xiaotong. Misdiagnosis analysis of 155 cases of lead poisoning reported in China from 2007 to 2018[J]. Occupational Health and Emergency Rescue, 2019, 37(6): 524-527. DOI: 10.16369/j.oher.issn.1007-1326.2019.06.005
Citation: LI Hongmei, LI Xia, BAI Jin, REN Xiaotong. Misdiagnosis analysis of 155 cases of lead poisoning reported in China from 2007 to 2018[J]. Occupational Health and Emergency Rescue, 2019, 37(6): 524-527. DOI: 10.16369/j.oher.issn.1007-1326.2019.06.005
shu

2007—2018年我国报告155例铅中毒误诊分析

Misdiagnosis analysis of 155 cases of lead poisoning reported in China from 2007 to 2018

    摘要
  • 摘要:
    目的 分析临床工作中铅中毒误诊的原因，为采取有效的预防措施提供依据。
    方法 查询中国知网、万方数据库、维普数据库2007—2018年铅中毒误诊相关文章，总结病例特点并进行综合分析。
    结果 155例铅中毒误诊病例中生活性铅中毒115例（占74.84%），职业性铅中毒39例（占25.16%）；误诊为消化系统疾病127例（占81.9%），误诊为血液系统疾病15例（占10%），误诊为神经系统疾病12例（占7%），误诊为副肿瘤性天疱疮1例（占1%）。误诊为消化系统疾病的患者中，造成有创损伤26例（占20.5%）；误诊为其他系统疾病的患者中，造成有创损伤5例（占17.9%）。误诊为不同系统疾病给患者造成有创诊治的概率差异无统计学意义（P>0.05）。
    结论 对不典型的铅中毒病例，经过全面检查才能得到正确诊断。临床医师需加强有关铅中毒知识的学习，对怀疑发生重金属中毒的患者，应尽早做相关检查，与其他疾病相鉴别，以免贻误治疗时机。

     

    Abstract:
    Objective The causes of misdiagnosis of lead poisoning in clinical work were analyzed to provide basis for taking effective preventive measures.
    Methods Inquiring the article on the misdiagnosis of lead poisoning in the past 10 years in CNKI, Wanfang database and Wipp database, the case characteristics were summarized and a comprehensive analysis was conducted.
    Results Among 155 misdiagnosed cases of lead poisoning, 115(74.84%) were living lead poisoning, 39(25.16%) were occupational lead poisoning, 127(81.9%) were misdiagnosed as digestive system diseases, 15(10%)as hematological system diseases, 12(7%) as nervous system diseases, and 1 case was misdiagnosed as paraneoplastic pemphigus. Among the patients misdiagnosed as digestive system diseases, 26(20.5%) cases were performed invasive diagnosis and treatment, and 5(17.9%)cases among other system diseases. There was no significant difference in invasive diagnosis and treatment of patients misdiagnosed as different system diseases (P>0.05).
    Conclusion For atypical cases of lead poisoning, a thorough examination should be done to obtain a correct diagnosis. Clinicians need to strengthen their knowledge about lead poisoning. For patients suspected with heavy metal poisoning, they should be checked as soon as possible to avoid delay in treatment.

     

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