甲状腺功能减退病人误诊原因分析

Causes Analysis of Misdiagnosis of Patients with Hypothyrosis

目的探索研究甲状腺功能减退病人误诊原因,为以提高诊断水平,减少误诊、漏诊率。方法以该院于2014年1月—2015年1月间收治的临床随访资料齐全的62例甲状腺功能减退患者中误诊的21例患者为研究对象,分析患者的临床症状和病情特征,针对每种误诊情况整理资料并讨论其误诊原因。结果根据甲状腺功能检查及常规实验室检查判断,对心脏疾病、、血液病、贫血、肾病、以及精神疾病、消化系统疾病的总误诊率为33.87%,其中心脏疾病最高,为8例,12.90%。经过治疗及转归,除1例因纠正低鈉血症并发髓鞘中央溶解症外,其余预后良好。结论临床上甲减临床表现错综复杂,应深入识别甲减各种不典型表现,配合检查,综合分析诊断,降低误诊率。

Objective To discuss the causes of misdiagnosis of patients with hypothyrosis in order to improve the diagnostic level and decrease the misdiagnosis and missed diagnosis rate. Methods 21 cases of misdiagnosis from 62 cases with hypothyrosis whose clinical follow-up materials were complete treated in our hospital from January 2014 to January 2015 were selected as the research object, the clinical symptoms and disease characteristics of the patients were analyzed, the materials were sorted out according to each misdiagnosis condition and the misdiagnosis causes were discussed. Results Judging from thyroid function examination and routine laboratory examination, the total misdiagnosis rate of heart disease, blood disease, anemia, kidney disease, mental disease and digestive system disease was 33.87%, among them, heart disease was the highest with 8 cases（12.90%）,after treatment and prognosis, except for 1 case corrected for hyponatremia complicated by central dissolution of myelin sheath, the other patients had good prognosis. Conclusion The clinical manifestations of hypothyrosis were complicated in clinic, we should deeply identify various atypical manifestations of hypothyrosis, be cooperated with examinations, comprehensively analyze the diagnosis and decrease the misdiagnosis rate.