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分析误诊漏诊的原因,可从中吸取教训,提高诊疗水平,特别对临床实践经历较短的年轻医生更为有益。笔者仅以在临床上经常迂到的某些眼病误诊漏诊的原因作一分析,供年轻眼科医生作参考,避免重犯类似错误。一,询问病史不全面,未掌握眼病发展的全过程,仅据个别症状即作出诊断,是造成误诊漏诊的重要原因之一。特别是青年医生中,有人对询问病史的重要意义认识不足,认为眼病的诊断主要靠他觉检查,从而忽视详细的问病史而造成误诊漏诊。如有一儿童自床上跌下,当时家属未发现任何异常,3日后因右眼外斜来院就诊,初步诊断为麻痹性外斜视,给予维生素B_1内服,肌肉注射维生素B_(12)等治疗。6日后又出现双上睑下垂,接诊医生仍从跌伤的角度着想,未进一步询问睑下垂的发病
Analysis of the causes of misdiagnosis and missed diagnosis can learn from them and improve the diagnosis and treatment level, especially for young doctors with short clinical experience. I only to clinically often tortured some of the misdiagnosis of eye diseases for an analysis of the reasons for the young ophthalmologist for reference, to avoid repeat similar mistakes. First, to ask the history is not comprehensive, did not grasp the whole process of eye disease development, diagnosis is based on individual symptoms that are misdiagnosed as one of the important causes of missed diagnosis. Especially among young doctors, some people do not know enough about the significance of asking medical history. They think that the diagnosis of eye diseases is mainly based on his examination, which ignores the detailed history of the medical history and causes misdiagnosis and missed diagnosis. If a child fell off the bed, no abnormality was found in the family members. After 3 days, the right eye diagonal came to the hospital for treatment. The patient was initially diagnosed as paralytic exotropia, given oral administration of vitamin B_1 and intramuscular injection of vitamin B_ (12). 6 days later appeared double ptosis, admissions doctors still fall from the perspective of injury, did not further question the incidence of ptosis