误诊疾病数据库2004—2013年单病种误诊文献研究:绒毛膜癌

A Study on Misdiagnosis Literature of Single Disease of Misdiagnosed Disease Database from 2004 to 2013:Choriocarcinoma

目的探讨绒毛膜癌(绒癌)的临床特征、误诊原因及防范措施。方法对2004—2013年发表在中文医学期刊并经遴选纳入误诊疾病数据库的绒癌误诊文献资料进行回顾性分析。结果本研究共纳入绒癌误诊文献60篇累计122例误诊病例,其中涉及误诊率文献2篇,误诊率45.45%。122例误诊为38种疾病共132例次,居前5位的误诊疾病依次为异位妊娠、肺结核、子宫肌瘤、流产、胎盘胎膜残留,其中异位妊娠占误诊总例次的57.58%。依据误诊疾病数据库制定的误诊后果评价标准,对纳入本研究的122例误诊后果进行评价,Ⅲ级误诊后果1例(0.82%),即发生误诊误治但未造成不良后果;Ⅱ级误诊后果121例(99.18%),即因误诊造成不良后果。误诊主要原因为经验不足、缺乏对本病的认识,未选择特异性检查方法,问诊及体格检查不细致等。结论绒癌是临床少数可治愈的肿瘤,提高认识,详细询问病史,及时行相关检查和仔细鉴别诊断是避免或减少本病误诊误治的关键。

Objective To investigate clinical features, misdiagnosed causes and preventive measures of choriocarci-noma （ CC） . Methods Clinical data of CC documented in misdiagnosis literature data base from 2004 to 2013 was retrospec-tively analyzed. Results A total of 60 articles （122 misdiagnosed patient） were included in this study, which included 2 ar-ticles about misdiagnosis rate, and the misdiagnosis rate was 45. 45%. The 122 patients were misdiagnosed as having 38 kinds of diseases for 132 times, the top 5 misdiagnosed diseases in order were eccyesis, pulmonary tuberculosis, hysteromyoma, abortion and retained afterbirth, and ratio of patients misdiagnosed as having eccyesis was 57. 58%. Misdiagnosed outcomes of the 122 patients were evaluated by evaluation criterion of misdiagnosis disease database, there were 1 patients （0. 82%） with grade Ⅲ outcome which did not cause serious consequence and 121 patients （99. 18%） with gradeⅡ outcome which caused serious consequence. The main causes of misdiagnosis were lack of experience and knowledge of this disease, without specific examinations and without carelessness inquiry and body examination and so on. Conclusion CC can be rarely cured in clin-ic, and therefore clinicians should improve knowledge, ask medical history carefully and give related examinations timely in order to avoid the misdiagnosis.