摘要
目的：分析急性胰腺炎（ＡＰ）误诊误治的原因。方法：对近５年来我院收治的１１２８例ＡＰ病人中误诊误治的１３２例进行回顾性总结与分析。结果：总误诊率为１１７％，主要误诊为急性胃肠炎４３例（３２５８％），胆系疾病３８例（２８７９％），肠梗阻１４例（１０６１％），胃肠穿孔１０例（７５％），阑尾炎９例（６８２％），黄疸型肝炎６例（４５５％），妊娠并发症６例（４５５％），间质型ＡＰ误诊为坏死型手术１０例（７５８％），胰腺癌３例（２２７％），左肾结石２例（１５２％）。误诊时未查血尿ＡＭＹ９７例，未查Ｂ超８０例。最后确诊依据为动态检查血尿ＡＭＹ升高１０３例，腹水ＡＭＹ升高４９例，Ｂ超诊断８９例，ＣＴ诊断６６例，手术确诊５８例。结论：对ＡＰ发病诱因重视不够；满足于原有疾病的诊断；对全腹膜缺乏全面分析；过分依赖辅助检查是主要误诊原因，并指出了误诊的后果以及减少误诊的具体措施。
The factors rlated to the misdiagnosis and mistherapy in acute pancreatitis(AP)were investigatde.From 1128 patients having acute pancreatitis admitted in lasts years,there were 132 patients misdiagnozed,the overeall misdiagnosis rate was 11.7%.The petients having acute pancreatitis were commonlly misdiagnozed as acute gastroenteritis 43 cases(32.58%),biliary diseases 38 cases(28.79%),intestinal obstruction 14 cases(6.82),icteric hepatitis 6 cases(4.55%),etc.As in 132 patients the diagnosis was mistaken,the serum and urinauy amylase tests were done in 97 case and B-type Ultrasonics examinations were not carried out in 80 cases.The correct diagnosis was evantually made according to the elevation of amylase in serum,urinary and ascites,B-type Ultrasonics examination CT scanning and operation. It could be concluded that the main causes of misdiagnoses and mistherapy in patients having AP were overlooking the predisposing factors to AP,being satisfied with the diagnosis of original examinations of diseases,incorrectly analyzing the pathology of general peritonitis and overdepending the amylase,B-type Ultrasonics and CT scanning.It should be stressed the srious outcome of misdiagnosis and mistherapy,and the measures should be taken in oder to reduce the chance of misdiagnosis and mistherapy.
出处
《华西医学》
CAS
1998年第4期459-460,共2页
West China Medical Journal
关键词
急性
胰腺炎
误诊
误治
Acute pancreatitis
Misdiagnosis
Mistherapy
