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目的 分析胰腺癌误诊和漏诊的原因 ,缩短首发症状到确诊的时间 ,提高胰腺癌早期诊断率和切除率。方法 回顾性分析 1991年至 1997年我院收治的 10 2例胰腺癌入院前诊断情况及住院后各项检查的诊断率。结果 首次症状到入院的时间平均为 197d ,首次黄疸至入院的时间平均为 6 0d ,首次院外就诊时误漏诊率 10 0 % ,院外多次就诊或住院后误诊率和漏诊率达 85 % ,,其中误诊最多的为消化性溃疡 (2 5例 ) ,其次是胆石症 (14例 )、肝炎 (11例 )、胆道蛔虫 (5例 )、骨质增生 (3例 )、结肠炎 (3例 )、其它 (3例 ) ,院外手术 8例 ,有 7例术中漏误诊 ;住院后超声诊断符合率 85 % ,CT诊断正确率 95 % ,术中发现腹腔广泛转移 6 0 % ,同时伴肝转移 40 % ,伴局部侵犯及淋巴转移 75 % ,根治术 10 % ,姑息切除 2 % ,非手术 10 %。结论 胰腺癌误漏诊率高 ,误漏诊时间长 ,根治率低 ,提高首次诊断率以缩短误诊时间是当务之急 ,尽早CT检查是目前最佳的手段。
Objective To analyze the causes of misdiagnosis and missed diagnosis of pancreatic cancer, to shorten the initial symptoms to the time of diagnosis and to improve the early diagnosis rate and resection rate of pancreatic cancer. Methods The data of 102 cases of pancreatic cancer admitted to our hospital from 1991 to 1997 were retrospectively analyzed, and the diagnostic rates of various inpatients after hospitalization were analyzed retrospectively. Results The first symptom to hospital for an average of 197d, the first time jaundice to admission average 60d, the first out-patient diagnosis of misdiagnosis rate 100%, multiple outpatient visits or hospital misdiagnosis rate and misdiagnosis rate of 85% ,, The most misdiagnosed cases were peptic ulcer (25 cases), followed by cholelithiasis (14 cases), hepatitis (11 cases), biliary ascariasis (5 cases), bone hyperplasia (3 cases) and colitis (3 cases) , The other (3 cases), 8 cases of out-of-hospital surgery, 7 cases missed misdiagnosis; hospitalized ultrasound diagnostic coincidence rate of 85%, CT diagnostic accuracy rate of 95%, found intraperitoneal extensive transfer of 60%, accompanied by liver metastasis 40%, with local invasion and lymph node metastasis 75%, radical surgery 10%, palliative resection 2%, non-surgical 10%. Conclusion The misdiagnosis rate of pancreatic cancer is high, the length of misdiagnosis is long and the cure rate is low. To improve the first diagnosis rate to shorten the misdiagnosis time is the most urgent task. As soon as possible, CT examination is the best method at present.