白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2013年
8期
483-486,490
,共5页
多发性骨髓瘤%诊断%误诊%荟萃分析
多髮性骨髓瘤%診斷%誤診%薈萃分析
다발성골수류%진단%오진%회췌분석
Multiple myeloma%Diagnosis%Misdiagnosis%Meta-analysis
目的 分析多发性骨髓瘤(MM)患者误诊疾病种类、误诊原因及避免误诊的对策.方法 在万方医学网以“多发性骨髓瘤”和“误诊”为关键词,检索2000年至2012年有关MM误诊分析的文献197篇,从中筛选出资料完整、统计确切、来自全国二级以上医院的文献62篇,进行分析总结.结果 62篇文献报道误诊患者2110例.MM误诊疾病种类达160余种,延误诊断时间最短1周,最长10年.初诊患者误诊率为56.44％(1406/2491).发病年龄16 ～ 87岁,文献报道的最大平均发病年龄和最小平均发病年龄相差近20岁(49.5岁比68.7岁).MM主要误诊为10大类疾病:骨关节病32.23％(680/2110)、其他血液病11.75％(248/2110)、感染14.50％(306/,2110)、实体肿瘤6.35％(134/2110)、肾脏病18.58％(392/2110)、消化系统疾病3.13 ％(66/2110)、风湿病4.64％(98/2110)、心脏疾病2.70％(57/2110)、神经系统疾病2.99％(63/2110)、内分泌系统疾病0.38 ％(8/2110).结论 MM可发生于除儿童以外的各个年龄段,可能被误诊为各种疾病,加强对MM的全面认识,通过详尽的病史询问,耐心细致的体格检查,全面的辅助检查,综合的临床思维,从现象认识本质是防止误诊的关键.
目的 分析多髮性骨髓瘤(MM)患者誤診疾病種類、誤診原因及避免誤診的對策.方法 在萬方醫學網以“多髮性骨髓瘤”和“誤診”為關鍵詞,檢索2000年至2012年有關MM誤診分析的文獻197篇,從中篩選齣資料完整、統計確切、來自全國二級以上醫院的文獻62篇,進行分析總結.結果 62篇文獻報道誤診患者2110例.MM誤診疾病種類達160餘種,延誤診斷時間最短1週,最長10年.初診患者誤診率為56.44％(1406/2491).髮病年齡16 ～ 87歲,文獻報道的最大平均髮病年齡和最小平均髮病年齡相差近20歲(49.5歲比68.7歲).MM主要誤診為10大類疾病:骨關節病32.23％(680/2110)、其他血液病11.75％(248/2110)、感染14.50％(306/,2110)、實體腫瘤6.35％(134/2110)、腎髒病18.58％(392/2110)、消化繫統疾病3.13 ％(66/2110)、風濕病4.64％(98/2110)、心髒疾病2.70％(57/2110)、神經繫統疾病2.99％(63/2110)、內分泌繫統疾病0.38 ％(8/2110).結論 MM可髮生于除兒童以外的各箇年齡段,可能被誤診為各種疾病,加彊對MM的全麵認識,通過詳儘的病史詢問,耐心細緻的體格檢查,全麵的輔助檢查,綜閤的臨床思維,從現象認識本質是防止誤診的關鍵.
목적 분석다발성골수류(MM)환자오진질병충류、오진원인급피면오진적대책.방법 재만방의학망이“다발성골수류”화“오진”위관건사,검색2000년지2012년유관MM오진분석적문헌197편,종중사선출자료완정、통계학절、래자전국이급이상의원적문헌62편,진행분석총결.결과 62편문헌보도오진환자2110례.MM오진질병충류체160여충,연오진단시간최단1주,최장10년.초진환자오진솔위56.44％(1406/2491).발병년령16 ～ 87세,문헌보도적최대평균발병년령화최소평균발병년령상차근20세(49.5세비68.7세).MM주요오진위10대류질병:골관절병32.23％(680/2110)、기타혈액병11.75％(248/2110)、감염14.50％(306/,2110)、실체종류6.35％(134/2110)、신장병18.58％(392/2110)、소화계통질병3.13 ％(66/2110)、풍습병4.64％(98/2110)、심장질병2.70％(57/2110)、신경계통질병2.99％(63/2110)、내분비계통질병0.38 ％(8/2110).결론 MM가발생우제인동이외적각개년령단,가능피오진위각충질병,가강대MM적전면인식,통과상진적병사순문,내심세치적체격검사,전면적보조검사,종합적림상사유,종현상인식본질시방지오진적관건.
Objective To summarize the types and reasons of misdiagnosis in multiple myeloma (MM),and the approaches of avoiding misdiagnosis by analyzing the misdiagnosis data in MM.Methods 197 references of misdiagnosed MM were retrieved from Wanfang medicine net by using the key words "multiple myeloma" and "misdiagnosis" from the year 2000 to 2012,and 62 of them with complete data and statistical certainty from level 2 or higher national hospitals were analyzed and summarized.Results In 62 references,2110 patients were misdiagnosis.There were more than 160 misdiagnosed MM.The shortest time of delay in diagnosis was one week,and the longest was tcn years.The rate of misdiagnosis in MM was 56.44 ％ (1406/2491).The onset age of the youngest was 16 years old and the oldest was 87 years old.A difference of nearly 20 years was found between the maximum and minimum average age of onset.MM was misdiagnosed as 10 kinds of diseases.They were including bone joint disease 32.23 ％ (680/2110),other blood diseases 11.75 ％ (248/2110),infection 14.5 ％ (306/2110),solid tumor 6.35 ％ (134/2110),kidney disease 18.58 ％ (392/2110),digestive system disease 3.13 ％ (66/2110),rheumatism 4.64 ％ (98/2110),heart disease 4.64 ％ (57/2110),nervous system disease 2.99 ％ (63/2110),endocrine disease 0.38 ％ (8/2110).Conclusion MM could occur in all ages except children and may be mistaken for a variety of diseases.It is key to prevent misdiagnosis by strengthening the comprehensive understanding of MM by taking detailed history,careful physical examination,comprehensive laboratory examination,and comprehensive clinical thinking.
