老年人内科急诊误诊87例临床分析

Elderly Medical Emergency Clinical Analysis of 87 Cases Misdiagnosed

目的研究老年患者内科急诊中误诊原因,探讨如何尽可能早期确诊及治疗,避免误诊误治,缩短病程,减轻病人痛苦。方法将2009年～2011年的3年内2万余老年内科急诊病人整理统计。结果老年患者的误诊,极大一部分与老年患者临床表现不典型,在早期检查结果阴性或辅助检查结果出现假阴性等有关,仅满足于与患者首发临床症状同一系统疾病的诊断,是误诊的一大原因;急诊的胸痛(胸部症状)及腹痛(腹部症状)仍是急诊鉴别诊断的重点,误诊的发生率也居高不下。结论强调病史、体格检查、辅助检查和正确的临床逻辑思维,任何时候都是医生诊断疾病不可缺少的基本要素。

Abstract= Objective To study the elderly patients in emergency medical misdiagnosis, on how early diagnosis and treatment as much as possible, to avoid misdiagnosis and mistreatment, shorten the course, relieve pains Methods 2009 years to 2011 years more than 20000 three years old medical emergency finishing statistics Results The results suggest that elderly patients and the incidenceof misdiagnosis of the disease and elderly patients are not susceptible to diseases （such as cardiovascular, diabetes, cancer, etc. ） by the same rate; elderly patients misdiagnosed a great part of the clinical manifestations in elderly patients is not typical test results; false negative only to be sati in the early negative S clinical symptoms or assisted such est fled of results related with the first the same system in patients with the diagnosis, is a majo~ cause of misdiagnosis; emergency department chest pain （chest symptoms） , and abdominal pain （abdominal symptoms） is still the focus of emergency differential diagnosis, high incidence of misdiagnosis. Gonclus history and physical ons emphasis on examination of auxiliary examination right clinical logical thinking, any time is a doctor diagnose disease indispensable basic elements.