大肠癌380例漏诊原因分析

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

目的 探讨大肠癌漏诊原因，提高大肠癌的早期诊断率。方法 对我院１９８４ 年至１９９３ 年期间收治的１ ０２０ 例大肠癌进行回顾性分析。结果 在该１ ０２０ 例大肠癌中，有３８０ 例被漏诊，漏诊率高达３７ ．３ ％ 。漏诊的主要原因是： ①忽视大肠癌早期症状，未做直肠指诊及粪便潜血检查； ②患者讳疾忌医； ③医生满足于原有良性疾病的诊治； ④早期未作肠镜、Ｘ 线钡灌肠等特殊检查。结论 为提高大肠癌的早期诊断率，对有大便性状和卫生习惯改变的患者，应常规进行直肠指诊和粪便潜血检查，必要时做肠镜和Ｘ 线钡灌肠检查，同时也应加强对本病的卫生科普知识宣传。

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.