ObjectiveTo explore the status,reasons and precautions of misdiagnosis of pulmonary sequestration. MethodsSeventy-seven articles about pulmonary sequestration published in Wanfang and CNKI databases between January 2005 and December 2013 were retrospectively analyzed,of which 41 articles referring to misdiagnosis rate.The misdiagnosis rate,time,status,consequence,reason and main means of definite diagnosis were analyzed. ResultsThe total number of cases of pulmonary sequestration in the 41 articles was 689,in whom 399 cases were misdiagnosed.Misdiagnosis rate was 57.91%.The minimum misdiagnosis time was 14 days and the maximum was 40 years.Pulmonary sequestration was most often misdiagnosed as pulmonary cyst(23.16%),bronchiectasis(22.73%),lung cancer(20.08%),lung abscess(6.93%)and pneumonia(6.28%).Most misdiagnosed patients did not suffer adverse consequences,except 4 patients were dead and 1 patient undertook unnecessary extended operation.Lack of specificity in clinical manifestations,lack of awareness of the disease,diversity of imaging performance and complications covering the original disease were the most common reasons of misdiagnosis.Postoperative pathological examination(83.77%),intraoperative findings(13.42%)and computed tomography angiography(2.16%)were the main means of definite diagnosis in misdiagnosed cases. ConclusionPulmonary sequestration is lack of specificity in clinical manifestations and easy to be misdiagnosed.Imaging showing the abnormal blood supply vessels is the key to the diagnosis.Improving the awareness of it can reduce misdiagnosis and incorrect treatment.
ObjectiveTo investigate the clinical efficacy of CoughAssist for cleaning airway secretions in neuromuscular disease patients with respiratory insufficiency. MethodsForty-six cases of neuromuscular disease with respiratory insufficiency were recruited in the study,with Guillain-Barre syndrome in 24 cases,myasthenia gravis in 18 cases,and multiple myositis in 4 patients.Thirty-four patients underwent intubation and mechanical ventilation,and 12 patients underwent tracheotomy.They were randomly divided into group A using CoughAssist and group B using suction tube to clear airway secretions after mechanical vibration.The frequency of suction within 24 hours,oxygenation index,pulmonary static compliance,incidence of lung infections,lung auscultation and chest radiograph were recorded and compared between two groups. ResultsCoughAssist could more effectively clean respiratory secretions with higher oxygenation index and pulmonary static compliance in group A.Lung auscultation and chest radiograph significantly improved,and the incidence of lung infection significantly decreased in group A compared with group B.Furthermore,CoughAssist reduced nursing workload with lower frequency of suction within 24 hours. ConclusionCoughAssist can effectively clean up airway secretions,improve oxygenation,while reducing pulmonary infection and nursing workload for neuromuscular disease patients with respiratory insufficiency,so it is aworthy tool in clincal practice.