18例溶组织内阿米巴致肝脓肿误诊分析

ANALYSIS OF MISDIAGNOSIS OF 18 CASES WITH CAUSED LIVER ABSCESS INDUCED BY ENTAMOEBA HISTOLYTICA

[目的]探讨临床对于阿米巴肝脓肿诊断错误的常见原因。[方法]对误诊18例阿米巴性肝脓肿进行回顾分析。[结果]阿米巴性肝脓肿临床表现复杂多样,易被误诊为细菌性肝脓肿等肝胆系统疾病;18例患者肝穿刺脓液直接涂片均查到溶组织内阿米巴滋养体而得以确诊。[结论]临床医师应加强对阿米巴肝脓肿临床表现及临床诊断的认识;尤其是临床检验师应熟悉溶组织内阿米巴形态结构,掌握阿米巴病的寄生虫学检查方法,避免阿米巴肝脓肿病的误诊。肝穿刺脓液直接涂片检查,其方法简单,快速,阳性率高。故对疑诊病人病原学诊断尤为重要,这是及时诊断溶组织内阿米巴肝脓肿的关键。

[Objective] To explore the common causes for clinical misdiagnosis of amoebic liver abscess. [Methods] 18 misdiagnosed cases of amebic liver abscess were retrospective analyzed. [Results] The clinical manifestations of amebic liver abscess were complicated and diverse, easily misdiagnosed as bacterial liver abscess and other hepatobiliary-system diseases. 18 cases of patients get confirmed by directly detection of Entamoeba Histolytica trophozoites with smears of liver puncture wound pus. [Conclusion] Clinicians should strengthen their understanding of the clinical manifestations and diagnosis, especially for clinical docimasters should familiarize with the formational structure of Entamoeba Histolytiea to grasp the parasitological testing method of anlebie-related diseases so as to avoid the misdiagnosis of Entamoeba Histolytica-caused liver abscess. The method of direct smears of liver puncture wound pus is simple, rapid and conducive to high positive rate. Therefore, it bears particular importance to etiological diagnosis of suspected patients and holds key to a timely diagnosis of Entamoeba Histolytica liver abscess.