Search

动脉导管未闭合并其他心脏畸形的临床分析

目的 探讨动脉导管未闭(PDA)合并其他心脏畸形的外科治疗经验. 方法 回顾性分析106例PDA合并其他心脏畸形的临床特点、手术方式与转归. 结果 死亡9例,住院死亡率8.5%,体外循环(CPB)前发现PDA与CPB后发现,住院死亡率差别有显著性意义(χ2＝6.383,Plt;0.05);术后发生并发症40例,术前漏诊与确诊PDA患者并发症的发生率差别有显著性意义(χ2＝5.388,Plt;0.05). 结论 在室间隔缺损、房间隔缺损、主动脉瓣或瓣下病变、主动脉缩窄、法洛四联症等心脏畸形进行手术治疗时,应特别注意是否合并PDA.提高术前及CPB前PDA诊断水平,对降低住院死亡率及并发症发生率具有重要意义.

ANALYSIS OF MISSED DIAGNOSIS IN COLORECTAL CANCER (REPORT OF 380 CASES)

Objective To analyse the causes of missed diagnosis in colorectal cancers and improve the early diagnosis. Methods A retrospective analysis was made to investigate the cause of missed diagnosis in 380 cases suffering from colorectal cancers.Results Of the 1 020 patients treated in our hospital in the past ten years (1984-1993), 380 patients were missed diagnosed, with the missed diagnosis rate of 37.3%. The main causes included: ①lacking attention to the early symptoms of colorectal cancers, neglecting the need to conduct certain tests such digital rectal examination and stool occult blood examination, ②delaying of seeking medical advice on the part of the patients, ③being satisfied with the diagnosis and treatment of benign disease, and ④neglecting certain special tests such as enteroscopy and barium enema examination of colon.Conclusion Routine use of rectal touch, occult blood examination and necessary use of special tests such as enteroscopy, barium enema examination of colon in patients suffering from stool change will increase the rate of accurate diagnosis of colorectal cancer.

急性主动脉夹层伴多器官灌注不良综合征一例

中间葡萄膜炎误漏诊病例分析

报告24例中间葡萄膜炎的误诊、漏诊病例，其中双眼患者19例。误诊、漏诊时间平均1年9个月。分析本病容易误诊和漏诊的原因除与本病自身的特点有关外，尚与医生对本病重视不够、认识不足和临床检查不全有很大关系。 （中华眼底病杂志，1993，9：87-88）

Image Feature and Analysis of Missdiagnosis of Endometrial Polyp by Transvaginal Ultrasound

Objective　To investigate the imaging characteristics of endometrial polyps by using transvaginal ultrasound and analyze the causes of misdiagnosis. Methods　Fifty-seven patients pathologically diagnosed of endometrial polyps were retrospectively analyzed. Results　The endometrial polyps had its own characteristics of ultrasound images, especially the lesion, size, shape, echo, border, color Doppler flow imaging (CDFI) and so on. Conclusion　Endometrial polyps has some special features on ultrasound image. Inspection in the secretary period, along with endometrial hyperplasia of the merger as well as multiple myoma the merger may result in misdiagnosis.

The Preventive Measures of Misdiagnosis and Missing Diagnosis of Blunt Abdominal Trauma

Objective To investigate the reasons of misdiagnosis and missing diagnosis in blunt abdominal trauma (BAT), and to put forward effective preventive measures. Methods Literature on BAT diagnosis in recent years was reviewed. Results Misdiagnosis and missing diagnosis, which can take place in every segment of BAT patients, were still quite common nowadays. Conclusion Detailed case history collecting, faithful medical examination and making good use of assistant examinations can efficiently decrease the misdiagnosis and missing diagnosis rates of BAT patients.

经肠镜检查误诊漏诊大肠癌28例分析

摘要:目的: 了解肠镜下误诊漏诊大肠癌的原因,探讨减少误诊、漏诊的方法。 方法 :回顾性分析本院1998～2008年经肠镜检查误诊漏诊的大肠癌患者的临床资料。 结果 :本院同期确诊大肠癌178例,经肠镜检查误诊漏诊28例,误诊漏诊率15.7%,其原因多为肠镜检查技术不熟练、检查不仔细、检查前准备不充分,以及肠镜诊断水平不高。 结论 :提高医务人员肠镜操作诊断水平,检查仔细、充分肠道准备可减少肠镜下大肠癌的误诊漏诊。

脉络膜血管瘤误诊三例分析

报告3例误诊的脉络膜血管瘤，本病容易漏诊、误诊，除与其本身特点有关外，主要是由于医生对本病缺乏认识，检查不全所致。 （中华眼底病杂志，1994，10：44-45）

肠系膜脂膜炎一例

回盲部结肠癌误诊为阑尾炎30例分析

【摘要】　目的　分析回盲部结肠癌误诊为阑尾炎的原因及如何避免误诊的方法。　方法　回顾性分析1998年1月－2010年10月误诊为阑尾炎的回盲部结肠癌患者30例的临床资料。其中男24例，女6例；年龄14～78岁，平均56岁。30例患者均行手术治疗，阑尾切除术中发现回盲部结肠癌28例而改行其他术式，其中一期右半结肠癌根治术12例，姑息性右半结肠切除术5例，回肠横结肠短路术6例，二期手术5例；1例于阑尾切除术后15 d发现回盲部结肠癌，行右半结肠癌根治术；1例于阑尾切除术后6个月因肠梗阻明确诊断而再次手术，行右半结肠癌根治术。20例术后行全身静脉联合化学疗法治疗。　结果　术后发生切口感染6例，经局部换药、抗感染及支持等治疗后切口丙级愈合；其余切口均甲级愈合。术后无肠漏发生。住院时间12～68 d，平均18 d，住院期间无死亡者。所有患者术后病理检查均证实为回盲部结肠腺癌，其中合并阑尾炎28例。20例获随访，随访时间3个月～12年，平均5.6年。6例因无法切除病灶而行回肠横结肠吻合短路手术，于术后6～15个月死亡；5例行姑息性右半结肠切除术，于术后9～27个月死亡；余9例随访2～12年无复发。同期收治回盲部结肠癌167例，误诊、漏诊率为18%。　结论　回盲部结肠癌有时易误诊为阑尾炎，或并发阑尾炎时易漏诊；应仔细询问病史，全面了解和掌握患者的病情，完善必要的辅助检查，不要盲目自信是防止误诊、漏诊的关键。