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目的:探讨以转移灶为首发症状的胃癌病例误诊原因,并提出减少误诊的措施。方法:回顾性分析我院收治的胃癌病例,对其中5例以转移灶为首发症状的患者的临床症状和体征,以及临床诊断和手术探查情况进行比较。结果:因转移性肿瘤本身较少见,在诊断前较少考虑,故易漏诊或误诊;其次,对此类肿瘤的临床特点不熟悉;另外,以转移瘤之症状或体征出现后就医,忽略原发癌的有关症状或主诉;医务人员分科诊治,均以重视和考虑本科疾患为主,所以术前诊断率不高。结论:提高对胃癌的认识水平,了解其特殊扩散转移方式,注重临床表现,综合应用各种辅助检查手段,减少误诊发生。
Objective: To investigate the causes of misdiagnosis of gastric cancer with metastasis as the first symptom and to propose measures to reduce misdiagnosis. Methods: A retrospective analysis of gastric cancer cases admitted to our hospital, in which 5 cases of metastases as the first symptom of patients with clinical symptoms and signs, as well as clinical diagnosis and surgical exploration were compared. Results: Due to the rare metastatic tumor itself, less consideration before diagnosis, it is easy to missed diagnosis or misdiagnosis; Second, the clinical features of these tumors are not familiar with; In addition, the symptoms or signs of metastases after treatment, neglect Primary cancer related symptoms or complaints; Medical staffing, all with emphasis and consideration of undergraduate disease, so preoperative diagnosis is not high. Conclusion: To improve awareness of gastric cancer, to understand its special diffusion and metastasis, pay attention to clinical manifestations, the comprehensive application of various auxiliary examination methods to reduce misdiagnosis.