摘要
目的 调查支气管肺癌诊断中存在的不足状态并分析相关因素。方法 不加选择地对200 例住院肺癌患者进行回顾性调查,内容包括:发现方式,首发症状及出现时间、初诊时间、初诊医院及诊断、确诊时间及医院、误诊病种。结果 无症状肺癌组的早期发现率明显高于因症就诊组(P<0.05)。咳嗽、痰血、胸痛、发热为肺癌的四大首发症状。首发症状至初诊时间平均39 天,初诊至确诊时间平均73 天。首诊误诊率44.8 % 。首诊医院在一、二级基层医院54.5 % ,三级综合性医院30 % 。确诊医院中三级专科医院占89 % 。三级专科医院与各级综合性医院的确诊病例有显著差异(P<0.01)。诊断延误者68 例(34 % ),其中病人就诊延误32 % ,医生延误68 % 。结论 肺癌延误诊断的主要责任在医疗单位,应进一步提高各级医疗单位尤其是综合性医院对肺癌早诊断的警惕性。
Objective The deferred and missed diagnosis of lung cancer and its reason were investigated.Methods Retrospective review was performed on 200 randomized and hospitalized lung cancer cases.The content included ways of cancer discovery,first day and first symptom,time of first visit to the first hospital,time and hospital with definite diagnosis,and kinds of deferred and missed diagnosis.Results The early discovery rate in symptomless lung cancer group was obviously higher than the group that visited doctor with symptom( P <0 05). Cough ,bloody sputum,chest pain and fever were the first four symptoms. The average time from first symptom to first visit was 39 days,from first visit to definite diagnosis was 73 days. Missed diagnosis rate at first visit was 44.8 %,54.5 % cases paid their first visit at first and second grade hospitals, 30 % at the third grade specialized hospital,which gave out 89 % definite diagnosis.Deferred and missed diagnosis occurred in 68 cases (34 %);32 % deferred by patients themselves and 68 % by doctors.Conclusion The major responsibility for deferred diagnosis of lung cancer seems to be lay on hospital. Alertness and masterly diagnostic method on early diagnosis should be paid by every grade hospital,especially those general hospitals.$$$$
出处
《肿瘤》
CAS
CSCD
北大核心
2000年第1期54-55,共2页
Tumor
关键词
肺肿瘤
诊断
误诊
临床分析
Lung neoplasms
Carcinoma,bronchogenic/diagnosis
Diagnostic errors
