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目的探讨右半结肠癌延误诊治的原因和预防措施。方法回顾性分析130例右半结肠癌的临床资料。误诊为急性阑尾炎19例,阑尾周围脓肿3例,粘连性肠梗阻2例。结果误诊病例占同期右半结肠癌病例总数的18.46%。其中22例术中发现右半结肠病变,快速冰冻切片确诊,16例当即行右半结肠切除,6例关腹后二期手术切除,未导致误治。余2例初次阑尾切除术后症状不减,进一步检查发现右半结肠癌而再次手术。结论重视右半结肠癌的特点、仔细询问病史、全面的体格检查、重视辅助检查、术中规范探察,可有效减少右半结肠癌的误诊误治。
Objective To investigate the causes and preventive measures of delayed diagnosis and treatment of right colon cancer. Methods Retrospective analysis of 130 cases of right colon cancer clinical data. Misdiagnosed as acute appendicitis in 19 cases, 3 cases of appendix abscess, adhesive intestinal obstruction in 2 cases. Results Misdiagnosed cases accounted for 18.46% of the total number of right colon cancer cases in the same period. Twenty-two of them were diagnosed as right-sided colonic lesion and confirmed by rapid frozen section. Sixteen patients underwent immediate right-sided colon resection and six of them underwent resection of the second stage of abdominal surgery. More than two cases of the first appendectomy symptoms diminished, further examination found that the right colon cancer and reoperation. Conclusion The importance of the right colon cancer, careful history, comprehensive physical examination, emphasis on auxiliary examination, intraoperative standard probe, can effectively reduce the right misdiagnosis and misdiagnosis of colon cancer.