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目的分析椎管内肿瘤误诊为腰椎间盘突出症的原因,降低临床误诊率。方法回顾18例被误诊为腰椎间盘突出症的椎管内肿瘤患者的临床资料,包括病史,发病特点,病程,临床表现及影像学特征,分析发生误诊的原因,以及纠正误诊的方法。归纳出两类疾病的各自特征及鉴别要点和方法。结果临床上椎骨内肿瘤容易误诊为腰椎间盘突出症,主要原因在于忽视详细的病史采集和体格检查、过多地依赖影像学检查、以诊断收集资料而不是以分析收集资料推导诊断,违背了正常的诊断程序。结论椎管内肿瘤和腰椎间盘突出症的病史、疼痛特点以及临床表现有明显不同,只要进行详细的病史采集和仔细的体格检查并结合必要的影像学资料,两者是可以鉴别的。
Objective To analyze the causes of misdiagnosis of spinal canal tumors as lumbar disc herniation and reduce the rate of clinical misdiagnosis. Methods The clinical data of 18 patients with spinal canal tumor misdiagnosed as lumbar disc herniation were retrospectively analyzed, including the history, characteristics, course of disease, clinical manifestations and imaging features. The causes of misdiagnosis and the methods to correct the misdiagnosis were analyzed. Summarized the two characteristics of the disease and identify the main points and methods. Results The clinical diagnosis of vertebral disc herniation easily misdiagnosed as lumbar disc herniation, mainly due to the neglect of detailed medical history and physical examination, too much reliance on imaging examination to collect rather than diagnose the data collected to infer the diagnosis, contrary to the normal Diagnostic program. Conclusion The history of intraspinal canal tumor and lumbar disc herniation, pain characteristics and clinical manifestations are significantly different, as long as the detailed history of the acquisition and careful physical examination combined with the necessary imaging data, the two can be identified.