系统性红斑狼疮的误诊、延诊与临床思维

The Relationship between Clinical Thinking and Misdiagnosis or Delay-Diagnosis of Systemic Lupus Erythematosis

从临床思维的角度对误诊,延诊的系统性红斑狼疮72例进行分析.误诊,延诊率高达75%,其原因主要是询问病史和检查时顾及一点.忽略整体;思维局限于原有的疾病,将两种病诊为一种病;当稀有表现成为突出症状时,将一种病诊为两种病;鉴别诊断未能抓住实质性问及.针对这些情况,认真询问病史,注意早期诊断的线索,及时作免疫学检查,才能提高诊治水平.

72 cases with systemic lupus erythematosis (SLE) who were misdignosed or delay-diagnosed were analyzed at the angle of clinical thinking.The misdiagnosis or delay-diagnosis rate was as high as 75%. The main causes were as follows: history inquiry and examinations were inadequately concentrated on one point,neglecting the others as a whole; Thinking was conflned to original diseases,diagnosing only one of the two diseases; One disease was misdiagnosed as two when rare manifestations became prominant: substantial problems could not be grasped in differential diagnosis. For improving the diagnosis and treatment level of SLE, much attention should be paid to the following: the serious history inquirg, the early diagnostic clues and the timely immunologic examinations.