原发性胆囊癌52例临床误诊分析及预防措施

52 Cases of Primary Gallbladder Cancer Clinical Misdiagnosis Analysis and Its Preventive Measures

目的分析原发性胆囊癌临床误诊原因,探讨预防临床误诊的有效措施。方法回顾性分析胆囊切除患者1537例的临床资料,其中原发性胆囊癌患者68例,术前误诊52例,分析误诊原因并探讨预防措施。结果 52例原发性胆囊癌患者误诊疾病的误诊率比较,差异有统计学意义(P<0.01);52例不同年龄误诊患者构成比比较,差异有统计学意义(P<0.01);胆囊壁厚度不同误诊患者的构成比比较,差异有统计学意义(P<0.01)。结论原发性胆囊癌多误诊为胆囊结石及急性胆囊炎,因忽视原发性胆囊癌易与其他胆道疾病共存的特点、过度依赖B超检查及缺乏对疾病的全面认识所造成,加强对高危人群的检查及相关实验室检查,必要时行术中病理冷冻切片检查可有效减少误诊的发生。

Objective To analyze the clinical misdiagnosis of primary gallbladder to explore effective measures to prevent misdiagnosis.Methods Retrospective analysis of 1537 cases of cholecystectomy patients,68 patients with primary gallbladder carcinoma,52 cases were misdiagnosed and discuss the reasons for preventive measures.Results 52 cases of primary gallbladder carcinoma misdiagnosed misdiagnosis rate of disease,the difference was statistically significant（P〈0.01）;52 patients with different proportions of patients misdiagnosed the age,the difference was statistically significant（P〈0.01）;gallbladder wall thickness of the different proportions of patients misdiagnosed,the difference was statistically significant（P〈0.01）.Conclusion The misdiagnosis of gallbladder cancer more easily because of neglect of gallbladder coexist with other features of biliary tract disease,over-reliance on the lack of B-ultrasound and comprehensive understanding of disease caused by strengthening the inspection high-risk groups,the relevant laboratory Check the results of vigilance and strengthen the intraoperative frozen section pathological examination can be effective in reducing the incidence of misdiagnosis.