中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
22期
111-112
,共2页
直肠癌%延误诊断%影响因素%对策措施
直腸癌%延誤診斷%影響因素%對策措施
직장암%연오진단%영향인소%대책조시
Colorectal cancer%Delayed diagnosis%Influence factor%Countermeasure
目的：研究探讨导致直肠癌延误诊治的主要原因以及相应的临床处理措施。方法：收治延误诊治的直肠癌患者19例作为研究对象，对患者的基本临床资料进行回顾，分析患者延误诊治的主要原因及影响因素，并针对不同的原因制定针对性的临床处理措施，观察患者的临床治疗效果，统计治疗有效率并进行5～7年的随访。结果：经再次检查确诊的患者，按病理类型分类，高分化腺癌2例，中分化腺癌10例，低分化腺癌4例，黏液腺癌1例，乳头状腺癌2例；按照直肠癌的Dukes改良分期标准分类，B2期8例，C1期6例，C2期3例，D期2例。根据患者的病情分别实施化疗(2例)，直肠癌根治术(12例)，姑息手术(5例)。治疗后，对患者进行5～7年的随访，患者的1年生存率78.9%(15/19)，3年生存率52.6%(10/19)，5年生存率26.3%(5/19)。结论：导致直肠癌的诊断和治疗发生延误的原因涉及到患者自身对相关疾病知识和医疗常识的匮乏、医护工作者的医疗水平、医生在诊断中的疏忽等。医院要从提高直肠癌的临床检测技术和加强医护工作者的责任心培养，强化对相关疾病知识的普及入手，降低直肠癌延误诊断的发生率，提高临床治疗的有效率。
目的：研究探討導緻直腸癌延誤診治的主要原因以及相應的臨床處理措施。方法：收治延誤診治的直腸癌患者19例作為研究對象，對患者的基本臨床資料進行迴顧，分析患者延誤診治的主要原因及影響因素，併針對不同的原因製定針對性的臨床處理措施，觀察患者的臨床治療效果，統計治療有效率併進行5～7年的隨訪。結果：經再次檢查確診的患者，按病理類型分類，高分化腺癌2例，中分化腺癌10例，低分化腺癌4例，黏液腺癌1例，乳頭狀腺癌2例；按照直腸癌的Dukes改良分期標準分類，B2期8例，C1期6例，C2期3例，D期2例。根據患者的病情分彆實施化療(2例)，直腸癌根治術(12例)，姑息手術(5例)。治療後，對患者進行5～7年的隨訪，患者的1年生存率78.9%(15/19)，3年生存率52.6%(10/19)，5年生存率26.3%(5/19)。結論：導緻直腸癌的診斷和治療髮生延誤的原因涉及到患者自身對相關疾病知識和醫療常識的匱乏、醫護工作者的醫療水平、醫生在診斷中的疏忽等。醫院要從提高直腸癌的臨床檢測技術和加彊醫護工作者的責任心培養，彊化對相關疾病知識的普及入手，降低直腸癌延誤診斷的髮生率，提高臨床治療的有效率。
목적：연구탐토도치직장암연오진치적주요원인이급상응적림상처리조시。방법：수치연오진치적직장암환자19례작위연구대상，대환자적기본림상자료진행회고，분석환자연오진치적주요원인급영향인소，병침대불동적원인제정침대성적림상처리조시，관찰환자적림상치료효과，통계치료유효솔병진행5～7년적수방。결과：경재차검사학진적환자，안병리류형분류，고분화선암2례，중분화선암10례，저분화선암4례，점액선암1례，유두상선암2례；안조직장암적Dukes개량분기표준분류，B2기8례，C1기6례，C2기3례，D기2례。근거환자적병정분별실시화료(2례)，직장암근치술(12례)，고식수술(5례)。치료후，대환자진행5～7년적수방，환자적1년생존솔78.9%(15/19)，3년생존솔52.6%(10/19)，5년생존솔26.3%(5/19)。결론：도치직장암적진단화치료발생연오적원인섭급도환자자신대상관질병지식화의료상식적궤핍、의호공작자적의료수평、의생재진단중적소홀등。의원요종제고직장암적림상검측기술화가강의호공작자적책임심배양，강화대상관질병지식적보급입수，강저직장암연오진단적발생솔，제고림상치료적유효솔。
Objective:To study and explore the primary causes and corresponding clinical treatment countermeasures of delayed diagnosis and treatment of rectal cancer.Methods:19 rectal cancer patients with delayed diagnosis and treatment were selected. They were as the research objects.The basic clinical data of patients were reviewed.The main reasons and influencing factors of delayed diagnosis and treatment of patients were analyzed.The specific clinical treatment countermeasures were formulated in view of the different reasons.The clinical curative effects of patients were observed.The treatment effective rate was statistics and the patients were given 5 to 7 years follow-up.Results:The patients were confirmed by checking again,according to the pathologi-cal classification;2 cases were high differentiated adenocarcinoma;10 cases were moderately differentiated adenocarcinoma;4 cas-es were low differentiated adenocarcinoma;1 case was mucinous adenocarcinoma;2 cases were papillary adenocarcinoma.Accord-ing to the colorectal cancer Dukes improvement staging standards classification,8 cases were B2 stage;6 cases were C1 stage;3 cases were C2 stage;2 cases were D stage.The treatment was respectively implemented according to the condition of patients,2 cases were chemotherapy;12 cases were radical resection of rectal carcinoma;5 cases were palliative operation.After treatment,the patients were given 5 to 7 year follow-up.The 1 year survival rate of patients was 78.9%(15/19);the 3 year survival rate was 52.6%(10/19);the 5 year survival rate was 26.3%(5/19).Conclusion:The reasons of delayed diagnosis and treatment of rectal cancer are related with the lack of related disease knowledge and medical knowledge of patients,the medical level of health care workers,the negligence of doctor in the diagnosis.The hospital should improve the clinical testing technology of colorectal cancer and strength-en the responsibility cultivation of health care workers,and strengthen the popularization of related diseases knowledge.It reduce the incidence rate of delayed diagnosis of colorectal cancer,and improve the clinical treatment efficiency.
