结直肠癌38例误诊原因临床分析.docVIP

结直肠癌38例误诊原因临床分析[摘要] 目的:回顾性分析38例结直肠癌的误诊原因,以期进一步提高早期诊断率。方法:我院1998年1月～2008年12月共确诊结直肠癌82例,误诊38例。误诊时间最短4.5个月,最长21.0个月,平均9.6个月。结果:本组误诊率为46.34%(38/82),易误诊为痔疮、肠炎及急、慢性痢疾。结论:对有肠道症状的患者,按良性疾病治疗效果不佳时,应想到结直肠癌的可能,及时行结肠镜检查及肛门指诊检查,可降低结直肠癌的误诊率。 [关键词] 结直肠癌;误诊;原因分析 [中图分类号] R735.3+7 [文献标识码] B[文章编号] 1673-7210(2010)02(c)-134-02 Clinical analysis of misdiagnosis reasons in 38 cases of misdiagnosed colorectal cancer BAI Hongzhi1, ZHANG Yinfeng1, CHEN Fei2, WANG Yong2, ZHAI Yunqi2 (1.Daqing Oilfield General Hospital Group Bachang Hospital, Heilongjiang Province, Daqing 163514, China; 2.Daqing Oilfield General Hospital Group Longnan Hospital, Heilongjiang Province, Daqing 163453, China) [Abstract] Objective: To retrospectively analyze the misdiagnosis reasons of 38 cases of colorectal cancer and increase the diagnosis rate in the early stage. Methods: From January 1998 to December 2008, a total of 82 cases were confirmed as colorectal cancer in our hospital, 38 cases were misdiagnosed. Misdiagnosing time was between 4.5 months and 21.0 months, with an average time of 9.6 months. Results: The misdiagnosis rate in this group was 46.34% (38/82). They were easily misdiagnosed as hemorrhoids, enteritis and colorectal polypus. Conclusion: There are some imperative measures to decrease misdiagnosis by examining colo endoscopy and anus-rectum finger check, when the patients who have diarrhoea have not effective results, we should consider the possibility of colorectal cancer. [Key words] Colorectal cancer; Misdiagnosis; Analysis of reasons 结直肠癌是消化道常见的恶性肿瘤,近年来有增加的趋势,由于结直肠癌在早期常缺乏特异性的临床表现,故常易延误诊断。为了加深对本病的认识,笔者收集我院临床病例资料,对结直肠癌发生误诊的原因进行回顾性分析,以期提高结直肠癌的早期诊断和治疗,现将临床分析报道如下: 1 材料与方法 1.1 一般资料 1998年1月～2008年12月我院共确诊结直肠癌82例,其中误诊38例。误诊患者中,男性26例,女性12例;年龄24～75岁,其中,24～30岁3例,31～59岁21例,60～75岁14例。38例患者的主要临床症状有:①食欲减退、消瘦、乏力14例;②腹胀、腹痛19例;③血便或黏液血便23例;④黑便9例;⑤腹泻或便秘26例;⑥排便困难、大便变细或伴里急后重感27例;⑦腹部包块16例;⑧贫血21例。 1.2 方法 以患者在我院或外院门诊就诊3次以上为限,3次就诊未能确诊为结直肠癌者属误诊。在38例中,因早期不愿接受钡剂灌肠或结肠镜检查而误诊的患者有24例,多为青年女