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目的研究老年患者内科急诊中误诊原因,探讨如何尽可能早期确诊及治疗,避免误诊误治,缩短病程,减轻病人痛苦。方法将2009年～2011年的3年内2万余老年内科急诊病人整理统计。结果老年患者的误诊,极大一部分与老年患者临床表现不典型,在早期检查结果阴性或辅助检查结果出现假阴性等有关,仅满足于与患者首发临床症状同一系统疾病的诊断,是误诊的一大原因;急诊的胸痛(胸部症状)及腹痛(腹部症状)仍是急诊鉴别诊断的重点,误诊的发生率也居高不下。结论强调病史、体格检查、辅助检查和正确的临床逻辑思维,任何时候都是医生诊断疾病不可缺少的基本要素。
Objective To study the causes of misdiagnosis in elderly patients with medical emergency and to explore how to diagnose and treat as soon as possible, to avoid misdiagnosis and mistreatment, to shorten the course of disease and to alleviate the suffering of patients. Methods Twenty thousand elderly medical emergency patients in 2009 ~ 2011 were collected and analyzed. Results The misdiagnosis of elderly patients, a large part of the clinical manifestations of elderly patients with atypical, negative results in the early examination or false negative results such as the auxiliary examination, only to meet with patients with clinical symptoms of the same system diagnosis of the disease is misdiagnosed The main reason; emergency chest pain (chest symptoms) and abdominal pain (abdominal symptoms) are still the focus of differential diagnosis of emergency diagnosis, the incidence of misdiagnosis is also high. Conclusions Emphasis on medical history, physical examination, laboratory examinations and correct clinical logic is an indispensable element of a doctor’s diagnosis of a disease at all times.