摘要
目的:分析急性胰腺炎误诊误治原因,总结经验、教训,提高诊断及治疗水平。方法:检索1989～2003年中文期刊全文数据库报道有关急性胰腺炎误诊误治为其他疾病的文献46篇,共646例,男311例,女335例,平均年龄44.18岁。重症急性胰腺炎228例,轻症急性胰腺炎418例。大学医院报道211例,省、市级医院报道272例,县级医院报道151例,区级医院报道12例。结果:主要误诊为胃肠疾病332例;肝胆疾病217例;心血管疾病41例;妇产科疾病24例;其它疾病32例。总死亡60例,术后死亡55例,非手术死亡5例。最后确诊依据为动态血尿淀粉酶升高405例,动态B超检查374例,CT检查264例,手术证实247例。结论:满足于原有疾病的诊断;对诱因认识肤浅;对全腹膜炎缺乏正确分析;对特殊类型胰腺炎缺乏经验;对辅助检查缺乏客观分析是误诊的主要原因并指出了减少误诊误治的具体措施。
Objective： To analyse the causes of misdiagnosis and mistherapy in acute pancreatitis （AP） and sunmarize the experiences and lessons in order to improve the diagnostic and therapeutic levels. Methods： Forty - Six literatures in which AP were misdiagnosed as other diseases were searched among database of Chinese journal from 1989 to 2003. There were 646 cases in total, including 311 male cases and 335 female cases. An average age was 44.18 years old. In these cases, 228 were severe acute pancreatitises and 418 mild acute panereatitises. Two- hundred and eleven cases were reported from university hospital, and other 272, 151 and 12 eases were from provincial or city hospitals, county hospitals and country hospitals, respectively. Resuits： Three- hundred and thirty- two cases with AP were mainly misdiagnosed as gastrointestinal diseases, liver and biliary diseases in 217 caeses, cardiovascular diseases 41 cases, gynecological and obstetrical diseases 24 eases and other diseases 32 cases. Sixty patients died, including 55 eases after operation and 5 cases without operation. The correct diagnosis was eventually made according to the elevation of amylase in serum or urine on 405 eases, B - type ultrasonic examination in 374 cases, CT scanning in 264 cases and operation 247 eases. Conclusion： The main causes of misdiagnosis were being satisfied with the original diagnosis, superficial understanding of predisposing condition, lack of correct analysis the causes of general peritonitis, lack of knowledge of those special-type of pancreatitis and mistakes in the analysis of the assistant examination. The measures in order to reduce the ate of misdiagnosis and mistherapy were postulated.
出处
《华西医学》
CAS
2005年第3期433-435,共3页
West China Medical Journal
基金
四川省中医药管理局科研课题资助(合同号:2000212)
