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[综合医院新型冠状病毒肺炎与类似肺部疾病的鉴别诊断]

[The differential diagnosis for novel coronavirus pneumonia and similar lung diseases in general hospitals].

作者信息

Tian X L, Peng M, Wang H P, Cai B Q, Xu W B, Zhu Y J, Li T S, Zhu H D, Song L, Wang M Z, Zhang L, Shi J H

机构信息

Department of Pulmonary Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

Department Infection Disease, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2020 May 12;43(5):401-408. doi: 10.3760/cma.j.cn112147-20200221-00136.

Abstract

Novel coronavirus pneumonia was a novel coronavirus infection that has dominated pulmonary infection since December 2019. The main manifestations were fever, dry cough, shortness of breath, normal or leukopenia in peripheral blood and changes in chest CT and in severe cases, multiple organ failure might occur. The National Health Commission, PRC has revised the consensus on diagnosis and treatment seven times in a short period of time, indicating the growing understanding of the disease. Patients with novel coronavirus pneumonia usually had history of travelling or living in the epidemic area including Wuhan within 14 days before onset, or have been exposed to patients who had fever or respiratory symptoms from the epidemic area, or had clustering diseases. However, novel coronavirus pneumonia was becoming more and more blurred after vanishing epidemic. The diagnosis and differential diagnosis of novel coronavirus pneumonia were challenges not only because of large number of tourists increasing dramatically after the relieving of epidemic, but also patients with other diseases from different areas to search for medical care. In this article, the clinical and chest imaging features of the novel coronavirus pneumonia were reviewed and compared with other infections and non-infectious diffuse pulmonary diseases. We try to find the similarities and differences among them, and to identify clues to the diagnosis of novel coronavirus pneumonia, so as to ensure accurate diagnosis and treatment.

摘要

新型冠状病毒肺炎是一种自2019年12月以来主导肺部感染的新型冠状病毒感染。主要表现为发热、干咳、气短、外周血正常或白细胞减少以及胸部CT改变,严重时可能发生多器官功能衰竭。中华人民共和国国家卫生健康委员会在短时间内对诊断和治疗共识进行了七次修订,表明对该疾病的认识不断加深。新型冠状病毒肺炎患者通常在发病前14天内有在包括武汉在内的疫区旅行或居住史,或接触过来自疫区有发热或呼吸道症状的患者,或有聚集性发病情况。然而,在疫情消退后,新型冠状病毒肺炎变得越来越不清晰。新型冠状病毒肺炎的诊断和鉴别诊断面临挑战,这不仅是因为疫情缓解后大量游客急剧增加,还因为来自不同地区患有其他疾病前来就医的患者。本文回顾了新型冠状病毒肺炎的临床和胸部影像学特征,并与其他感染性和非感染性弥漫性肺疾病进行了比较。我们试图找出它们之间的异同,并识别新型冠状病毒肺炎的诊断线索,以确保准确诊断和治疗。

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