结直肠癌七例误诊原因分析

Analysis of Causes of Misdiagnosis in Seven Cases of Colorectal Cancer

目的分析结直肠癌(CRC)的误诊原因,并总结防范措施。方法对2019—2020年收治的7例CRC误诊患者的临床资料进行分析。结果本组误诊率为8.64%。7例因食欲减退、体质量下降、便血等原因就诊。被误诊为慢性胃肠炎2例,肠梗阻、结肠炎、胃肠炎+胆囊结石、痔、增生性贫血各1例,误诊时间为1~10(4.56±0.87)d。7例行对应治疗后病情并未好转,均行结肠镜、组织病理检查、便隐血试验、癌胚抗原等检查确诊为CRC。5例行择期手术治疗(根治性切除术+化疗),另2例给予化疗。7例在治疗后均病情好转出院,随访发现2例复发,5例预后良好。结论CRC早期表现不典型,接诊医生警惕性不高时易误诊,需要引起临床重视,在诊疗过程中需全面分析病情,重视针对性检查对提高CRC早期诊断有积极意义。

Objective To analyze the causes of misdiagnosis of colorectal cancer(CRC) and to summarize preventive measures. Methods The clinical data of 7 patients with misdiagnosed CRC admitted from 2019 to 2020 was analyzed. Results The misdiagnosis rate in this group was 8.64%. Seven cases presented with loss of appetite, weight loss, and blood in the stool, and were misdiagnosed as chronic gastroenteritis in 2 cases, and intestinal obstruction, colitis, gastroenteritis + cholecystolithiasis, hemorrhoids, and proliferative anemia in 1 case respectively. The duration of misdiagnosis ranged from 1 to 10(4.56±0.87) days. The condition of 7 cases did not improve after the corresponding treatment, and all were diagnosed as CRC by colonoscopy, histopathological examination, fecal occult blood test, carcinoembryonic antigen and other tests. Of them, 5 cases received elective surgery(radical resection + chemotherapy), and the other 2 cases received chemotherapy. All 7 cases improved and were discharged after treatment, of whom 2 cases of recurrence were found in follow-up, and 5 cases had good prognosis. Conclusion The early manifestations of CRC are atypical. It is more likely to be misdiagnosed for lack of vigilance of the doctor, which needs great attention in clincial practice In the process of diagnosis and treatment, it is necessary to comprehensively analyze the condition and pay attention to the targeted examination, which is of positive significance to improve the early diagnosis of CRC.