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目的通过对45例延误诊断的结直肠癌患者的资料进行分析,以提高早期结直肠癌诊断率。方法回顾分析2000年至2007年因结直肠癌或其他原因先后两次在本院住院治疗,最终诊断结直肠癌患者45例。结果便血24例,误诊直肠息肉16例,痔6例,慢性结肠炎2例。上腹痛10例,误诊胆囊结石、胆囊炎7例、急性胰腺炎3例。贫血4例,诊断缺铁性贫血。直肠癌侵及膀胱引起血尿2例,诊断前列腺增生。因腹泻诊断急性肠炎2例。其他原因住院3例。两次入院间隔时间1~12个月,平均6个月。行根治手术32例,姑息手术8例,5例未做手术。一年后随访有8例死亡,其平均生存期6个月。结论结直肠癌缺乏特异性的临床表现,易误诊为直肠息肉、结肠炎、痔疮、胆囊结石、胆囊炎等,临床工作中应注意病史搜集,对不明原因贫血、大便习惯改变、便血等提高警惕,对高危人群应行全结肠镜检筛查并积极治疗结直肠腺瘤。
Objective To analyze the data of 45 patients with delayed diagnosis of colorectal cancer in order to improve the diagnosis rate of early colorectal cancer. Methods Retrospective analysis from 2000 to 2007 due to colorectal cancer or other reasons twice hospitalized in our hospital, the final diagnosis of 45 patients with colorectal cancer. Results 24 cases of blood in the stool, misdiagnosis of rectal polyps in 16 cases, hemorrhoids in 6 cases, 2 cases of chronic colitis. Upper abdominal pain in 10 cases, misdiagnosed gallstones, cholecystitis in 7 cases, 3 cases of acute pancreatitis. 4 cases of anemia, diagnosis of iron deficiency anemia. 2 cases of rectal cancer invading the bladder caused by hematuria, diagnosis of benign prostatic hyperplasia. Diagnosis of acute enteritis due to diarrhea in 2 cases. Other reasons hospitalized in 3 cases. Two admission interval of 1 to 12 months, an average of 6 months. 32 cases of radical surgery, palliative surgery in 8 cases, 5 cases without surgery. Eight patients were followed up one year later, with an average survival of 6 months. Conclusion Colorectal cancer lacks specific clinical manifestations and is easily misdiagnosed as rectal polyps, colitis, hemorrhoids, gallstones, cholecystitis, etc. Clinical work should pay attention to the collection of history, vigilance on unexplained anemia, altered stool habits and blood in the stool , Colon cancer screening should be performed for high-risk groups and active treatment of colorectal adenoma.