论文部分内容阅读
目的分析血液细胞形态学中的误诊与漏诊。方法 31例血液细胞形态学误诊与漏诊患者为本次研究对象,以不抗凝外周血为其血涂片,检查其红细胞、血小板、寄生虫及血液白细胞数量。结果本次实验中,以生化检查+形态学检测的方式,对所有血液细胞进行检测,从而完成最终的确诊。其中误诊为肝细胞性黄疸证者10例确诊为遗传性球形红细胞增多症,误诊与漏诊5例(50.00%);误诊为双性贫血者10例确诊为冷凝集综合征,误诊与漏诊6例(60.00%);误诊为结核性脑膜炎6例确诊为血栓性血小板减少性紫癜,误诊与漏诊2例(33.33%);误诊为急性白血病5例确诊为流行性出血热,误诊与漏诊2例(40.00%)。血液细胞形态学误诊与漏诊患者经其他血液检查后,均能为其疾病诊断提供准确的检测依据。结论借助血液细胞分析仪展开血液细胞形态学的检测,有利于筛选血象异常者,而对于疑似病例则可借助显微镜等其他检查手段来控制误诊与漏诊的几率。
Objective To analyze misdiagnosis and missed diagnosis of blood cell morphology. Methods Totally 31 patients with misdiagnosis and missed diagnosis of blood cell morphology were selected as the study subjects. Blood samples were obtained from non-anticoagulant peripheral blood and the numbers of erythrocytes, platelets, parasites and blood leukocytes were examined. Results In this experiment, all the blood cells were detected by biochemical examination + morphological examination to complete the final diagnosis. Among them, 10 cases were diagnosed as hereditary polycythemia vera with misdiagnosed hepatocellular jaundice syndrome, and 5 cases were misdiagnosed and missed (50.00%); 10 cases misdiagnosed as bipolar anemia were diagnosed as condensation syndrome, 6 cases were misdiagnosed and missed diagnosis (60.00%); misdiagnosed as tuberculous meningitis in 6 cases diagnosed as thrombotic thrombocytopenic purpura, misdiagnosis and missed diagnosis in 2 cases (33.33%); misdiagnosed as acute leukemia in 5 cases were diagnosed as epidemic hemorrhagic fever, misdiagnosis and missed diagnosis in 2 cases (40.00%). Misdiagnosis and missed diagnosis of blood cell morphology in patients with other blood tests, can provide accurate diagnosis of disease diagnosis basis. Conclusions The detection of blood cell morphology by means of hematology analyzer is helpful for the screening of abnormal blood samples. For suspected cases, other means such as microscopy can be used to control the misdiagnosis and missed diagnosis.