皖南医学院学报
皖南醫學院學報
환남의학원학보
ACTA ACADEMIAE MEDICINAE WANNAN
2014年
4期
314-316
,共3页
盆腔结核%卵巢癌%误诊%CA125
盆腔結覈%卵巢癌%誤診%CA125
분강결핵%란소암%오진%CA125
pelvic tuberculosis%ovarian cancer%misdiagnosis%CA125
目的：探讨CA125升高的女性盆腔结核误诊为卵巢癌的原因，分析其与卵巢癌的鉴别要点及预防误诊措施。方法：回顾分析2003年5月～2013年12月我院12例盆腔结核患者误诊为卵巢癌的临床资料。结果：平均年龄（39．5±6．5）岁（15～69岁），血清CA125均升高，平均值（264．5±8．4）U/ml（48．7～616．9 U/ml），所有患者均主要表现为腹胀，5例明显消瘦，6例合并腹痛，2例合并月经改变，2例合并发热；B超检查提示10例盆腔可探及包块，8例盆腔探及少到大量积液，3例伴胸腔积液，胸腹水查抗酸杆菌均阴性；初步诊断考虑卵巢癌可能性大，经腹腔镜或开腹探查病理证实为盆腔结核。所有患者术后均接受抗结核治疗，10例治愈，1例术后16个月死于肠穿孔，1例失访。结论：卵巢癌与盆腔结核在发病年龄、临床症状、实验室及影像学检查等方面有多个相似之处，容易混淆，但仔细分析，能降低误诊率，从而减少不必要的过度治疗，改善预后。
目的：探討CA125升高的女性盆腔結覈誤診為卵巢癌的原因，分析其與卵巢癌的鑒彆要點及預防誤診措施。方法：迴顧分析2003年5月～2013年12月我院12例盆腔結覈患者誤診為卵巢癌的臨床資料。結果：平均年齡（39．5±6．5）歲（15～69歲），血清CA125均升高，平均值（264．5±8．4）U/ml（48．7～616．9 U/ml），所有患者均主要錶現為腹脹，5例明顯消瘦，6例閤併腹痛，2例閤併月經改變，2例閤併髮熱；B超檢查提示10例盆腔可探及包塊，8例盆腔探及少到大量積液，3例伴胸腔積液，胸腹水查抗痠桿菌均陰性；初步診斷攷慮卵巢癌可能性大，經腹腔鏡或開腹探查病理證實為盆腔結覈。所有患者術後均接受抗結覈治療，10例治愈，1例術後16箇月死于腸穿孔，1例失訪。結論：卵巢癌與盆腔結覈在髮病年齡、臨床癥狀、實驗室及影像學檢查等方麵有多箇相似之處，容易混淆，但仔細分析，能降低誤診率，從而減少不必要的過度治療，改善預後。
목적：탐토CA125승고적녀성분강결핵오진위란소암적원인，분석기여란소암적감별요점급예방오진조시。방법：회고분석2003년5월～2013년12월아원12례분강결핵환자오진위란소암적림상자료。결과：평균년령（39．5±6．5）세（15～69세），혈청CA125균승고，평균치（264．5±8．4）U/ml（48．7～616．9 U/ml），소유환자균주요표현위복창，5례명현소수，6례합병복통，2례합병월경개변，2례합병발열；B초검사제시10례분강가탐급포괴，8례분강탐급소도대량적액，3례반흉강적액，흉복수사항산간균균음성；초보진단고필란소암가능성대，경복강경혹개복탐사병리증실위분강결핵。소유환자술후균접수항결핵치료，10례치유，1례술후16개월사우장천공，1례실방。결론：란소암여분강결핵재발병년령、림상증상、실험실급영상학검사등방면유다개상사지처，용역혼효，단자세분석，능강저오진솔，종이감소불필요적과도치료，개선예후。
Objective:To conduct the root cause analysis for misdiagnosis of pelvic tuberculosis as ovarian cancer on elevated CA 125 basis for approaches to differential diagnosis.Methods:The clinical data were retrospectively analyzed in 12 patients with pelvic tuberculosis misdiagnosed as ovarian cancer in Yijishan Hospital between May 2003 and December 2013.Results:The patients aged from 15 to 69 years old with a mean age of 36.2 ±11.5 years,and elevated serum CA125 by from 48.7 to 616.9U/ml[mean (264.5 ±8.4) U /ml],and were characterized by complaint of abdominal distension,signifi-cant weight loss (5 cases),abdominal pain(6 cases),menstrual change(2 cases),or fever(2 cases).Ultrasound examination revealed pelvic mass in 9 cases and pelvic effusion to a certain degree in 8.Pleural effusion occurred in 3 cases,yet confirmed negative for acid-fast bacilli by laboratory work.The total patients were initially suspected as diagnosed as ovarian cancer and underwent either laparoscopy or laparotomy ,yet confirmed as pelvic tuberculosis on biopsy basis and received anti-TB therapy.Ten patients were cured,one died 16 months after the surgery due to intestinal perforation,and another one failed to be followed.Conclusion:Ovarian cancer resembles somewhat pelvic tuberculosis by the patient′s age,clinical symptoms,laboratory and imaging findings,which tends to lead to misdiagnosis.Nevertheless,careful analysis of the clinical data may prevent error diagnosis and over-treatment,but improve the prognosis.
