27例痔病误诊原因分析

Analysis on Misdiagnosis Causes of 27 Cases of Hemorrhoids

为探讨不同类型痔病的误诊原因，提高临床诊断水平，回顾性分析各种痔病107例，其中内痔52例，外痔29例，混合痔26例，比较3种痔病的误诊率及其误诊的疾病。结果显示，内、外痔及混合痔的误诊率分别是32．7％（17例）、17．2％（5例）和19．2％（5例）；3者主要误诊疾病分别是：低位早期直肠癌、直肠息肉、直肠脱垂（内痔）；肛裂、直肠肛门炎性病变、肛缘良性肿瘤（外痔）；直肠脱垂、肛门性病、低位直肠肿瘤（混合痔）。结果表明，痔病须与7种常见肛门直肠疾病仔细鉴别，痔病中内痔最容易误诊．误诊的主要原因是临床症状重叠、缺少相关实验室检查和直肠镜检应用率低。

For the aim of investigating the misdiagnosis causes of hemorrhoids at different type so as to enhance diagnosis level, authors analysed 107 hemorrhoids patients, including 52 cases of internal hemorrhoids,29 cases of external hemorrhoids,26eases of mixed hemrrhoids,and compared the misdiagnosis rate and misdiagnosed diseases of the three various hemorrhoids. As results, the misdiagnosis rate of the three hemorrhoids was 32.7%（17/52）,17.2%（5/29） and 19.2%（5/26） respectively;the main misdiagnosed diseases of internal hemorrhoids were early low rectal carcinoma, rectal polyp, rectal prolapse; of external hemorrhoids were anal fissure, recto-anal inflammation lesions, and benign tumor at anal edge; of mixed hemorrhoids were rectal prolapse ,anal venereal disease, and low rectal tumors. Above analytic results show that internal hemorrhoids was the diseases to be misdiagnosed easyliest（ P 〈0.05）. The hemorrhoids must be made as the differential diagnosis from 7 sorts of common anal and rectal disease. The main causes were clinical sign overlapped,lack of related laboratory examination and low application rate of proctoscope.