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目的分析24例四肢恶性黑色素瘤初次在院外就诊时存在诊治缺陷的原因。方法对我科2005年4月～2008年11月收治的24例四肢恶性黑色素瘤患者初次在外院就诊时采取的不正确诊断及治疗措施进行回顾性分析。结果 24例患者均在外院经过初次诊断或治疗,其中11例诊断方式不合理(采用了表面活检或穿刺活检),1例病理检查有误,10例患者手术方式不合理,5例患者治疗方式不完善,10例随访不完善。首诊三级医院11例,首诊二级医院9例,首诊镇级医院1例,首诊校医院诊所1例,首诊私人门诊2例。结论对恶性黑色素瘤最基本的活检以及治疗方法需规范化,对门诊就治的四肢软组织包块应提高警惕,同时应提高初次就诊医院的病理诊断水平。
Objective To analyze the causes of the diagnosis and treatment of 24 cases of malignant melanoma of the extremities during their first outpatient visit. Methods The retrospective analysis of 24 cases of extremity malignant melanoma who were treated in our hospital from April 2005 to November 2008 for the first time in outpatient visits was retrospectively analyzed. Results Twenty-four patients were diagnosed or treated in the first hospital outside the hospital. Among them, 11 cases were diagnosed unreasonably by using biopsy or surface biopsy, one case had pathological examination incorrectly, 10 cases had unreasonable operation and 5 cases were treated Imperfect, 10 cases of incomplete follow-up. The first three hospitals in 11 cases, 9 cases of first-diagnosed secondary hospitals, the first diagnosis of town-level hospitals in 1 case, the first clinic clinic in 1 case, the first visit to private clinics in 2 cases. Conclusion The most basic biopsy and treatment methods for malignant melanoma need to be standardized. Outpatient treatment of limb soft tissue mass should be vigilant, and the level of pathological diagnosis in the first hospital should be improved.