成人肾脏恶性肿瘤误诊原因的分析

The causes of incorrect diagnosis of abult malignant renal tumors

本文报告68例肾肿瘤的临床资料,其中18例误诊或术前未确诊。误诊原因有①对上腹肿物的患者未考虑肾肿瘤的可能,②忽视肾癌的肾外表现,③满足于静脉肾盂造影的非典型改变,④对继发性肾孟癌警惕不够,⑤缺乏尿路积血与肿瘤的鉴别经验,⑥辅助检查的误差。在分析误诊原因的基础下,作者提出了提高诊断正确率的意见。

This article presents the clinical material of 68 cases of adult renal tu-mors, 18(26.5%)of which were diagnosed incorrectly. Incorrect diagnosismay arise from: (1) a mass in the upper abdomen not being considered asa renal tumor, (2) overlook of the extra-renal manifestations of renalcarcinoma, (3) being satisfied with the nontypical X-ray changes of IVPand not making furthen examination with other methods, (4) lack ofvigilance for secondary carcinoma of renal pelvis, (5) lack of experienceof differentiating blood clot and tumor in the urinary system, (6) errorsin accessory examinations. According to the analysis of the causes of incor-rect diagnosis, the author makes the suggestions which are important to es-tablish correct diagnosis.