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目的 :分析大肠癌的误诊与漏诊原因 ,以提高早期诊断率 ,及时治疗。方法 :回顾性分析 1991年 8月至 2 0 0 2年 12月住院治疗的 4 32例大肠癌患者的临床资料。结果 :被误诊或漏诊的大肠癌患者 12 0例 ,误诊与漏诊率为 2 7.8%。平均误诊与漏诊时间为 7.3个月。误诊疾病为 :慢性肠炎 9例、痔 32例、细菌性痢疾 5例、消化性溃疡 2 0例、上消化道溃疡并出血 18例、缺铁性贫血 7例、泌尿系感染 2例、肠功能紊乱 4例、慢性阑尾炎、阑尾脓肿 17例、胆囊炎 6例。结论 :大肠癌误诊与漏诊的主要原因是 :1病史的询问和病程未作全面的分析 ,体格检查不细致 ;2对大肠癌的临床症状认识不足 ;3忽视直肠指检 ;4满足于某一疾病的诊断 ,对大肠癌可以和直肠肛管其它良性疾病并存认识不足 ;5肠镜操作技术不熟练或操作不细心 ,肠镜检查前肠道准备欠妥 ;6不重视肠镜检查
Objective: To analyze the causes of misdiagnosis and missed diagnosis of colorectal cancer in order to improve the early diagnosis rate and timely treatment. Methods: The clinical data of 4 32 patients with colorectal cancer hospitalized from August 1991 to December 2002 were analyzed retrospectively. Results: 120 cases of colorectal cancer were misdiagnosed or missed diagnosis, misdiagnosis and misdiagnosis rate was 2 7.8%. The average time of misdiagnosis and missed diagnosis was 7.3 months. Misdiagnosed diseases: 9 cases of chronic enteritis, hemorrhoids in 32 cases, 5 cases of bacterial dysentery, 20 cases of peptic ulcer, upper gastrointestinal ulcer and bleeding in 18 cases, iron deficiency anemia in 7 cases, urinary tract infection in 2 cases, intestinal function 4 cases of disorder, chronic appendicitis, appendiceal abscess in 17 cases, cholecystitis in 6 cases. Conclusion: The main causes of misdiagnosis and missed diagnosis of colorectal cancer are: 1 history of the inquiry and the course of the disease is not a comprehensive analysis of physical examination is not detailed; 2 on the clinical symptoms of colorectal cancer lack of knowledge; 3 ignore the digital rectal examination; 4 to meet a Disease diagnosis, colorectal cancer and other benign diseases of the rectum anomaly coexistence of lack of understanding; 5 unscrupulous colonoscopy operation or operation is not careful, bowel preparation before colonoscopy is not properly prepared;