摘要
目的分析原发性胆囊癌误诊原因,探索有效的预防措施。方法我院1995年1月至2006年5月共收治原发性胆囊癌患者46例,对其临床资料进行回顾性分析。结果术前明确诊断14例(占30.4%)。误诊32例(占69.6%),术中误诊6例(占13.0%)。合并胆囊结石者18例(占39.1%),胆囊息肉样病变8例(占17.4%)。术前诊断为胆囊结石、胆囊炎21例(占45.7%)。超声检查阳性率43.5%,CT检查阳性率66.7%,螺旋CT增强检查阳性率83.3%。结论误诊原因并发胆囊其它疾病;缺乏特异性临床表现,对发病情况认识不足;过分依赖影像学检查;术中对可疑病灶未做冰冻病理检查。预防措施熟悉胆囊癌的临床特点;可疑病例术前需完善检查;积极手术治疗癌前病变;术中可疑病灶应做冰冻病理检查。
Objective： To analyze the reason of the misdiagnosis on primary gallbladder carcinoma and search the effective measures of prevention. Methods： Altogether 46 cases were treated in our hospital from January 1995 to May 2006, retrospective study was used to analyze the clinical data of 32 misdiagnosis cases in them. Results： misdiagnosis rate 69.6 %, there were 26 cases before operation （81.3%）, 6 cases during operation （ 18.7% ）. Among those, accompanied with gallstone 18 cases （39. 1%）, gallbladder polyp 8 cases （17.4%）. Before operation, those were diagnozed as gallstone and gallbladder polyp 21 cases （45.7%）. The diagnostic accuracy for ultrasonography was 43.5%, for CT was 66.7%, for spiral CT was 83.3%. Conclusion： misdiagnosis reasons： with other gallbladder disease, lack of distinctive clinical feature and recognition for gallbladder carcinoma, excessively depend on imaging methods, not take quick pathology during operation in dubious condition. Prevention measures： familiarize clinical character of gallbladder carcinoma, to the dubious, preoperative examination should be taken, actively resect lesions before turned into cancer, take quick pathology in time during operation if necessary.
出处
《现代肿瘤医学》
CAS
2007年第2期225-227,共3页
Journal of Modern Oncology
关键词
原发性胆囊癌
误诊
预防
primary gallbladder carcinoma
misdiagnosis
prevention
