CAJ | 학술논문

目的总结其他疾病误诊为颞下颌关节紊乱病(TMD)的情况,分析其原因,同时探讨描述此类文献术语的合理性.方法电子检索Medline(via OVID)和EMBASE 数据库,中国生物医学文献数据库网络版(CBM)、中国期刊全文数据库(CNKI)和中文科技期刊全文数据库(维普),终止检索时间为2011年12月.收集相关文献总结误诊为颞下颌关节紊乱病的其他疾病情况,资料提取由两名检阅者独立分开完成.同时,搜索名为“系统评价”的总结病例报道或病案系列的“文献综述”类文章,探讨对此类文章命名为“系统评价”的合理性.结果共检索到国内外文献315篇,最终纳入21篇(57例),均为病例报道或临床综述.该57例被误诊为颞下颌关节紊乱病的病例分别有上颌第三磨牙慢性冠周炎(43.86%)、鼻咽癌(15.79%)、颌面部肿瘤(15.97%)等20种疾病,误诊的原因主要有:临床表现类似(33.96%)、主诉相混淆(26.43%)及认识上不足(22.64%)等.同时,检索到标为“系统评价”的病例报道类“文献综述”文章35篇,中文27篇,英文8篇,均缺乏对病例报道真实性的评价,也没有方法学质量评价.结论其他疾病被误诊为颞下颌关节紊乱病主要发生在其临床表现极为相似的一些疾病,患者的主诉容易造成混淆,医务人员专业素质欠缺,工作责任心不够强亦有一定关系.在命名此类总结病例报道或病案系列文章时,最好使用“文献综述”,而不用“系统评价”.
목적총결기타질병오진위섭하합관절문란병(TMD)적정황,분석기원인,동시탐토묘술차류문헌술어적합이성.방법전자검색Medline(via OVID)화EMBASE 수거고,중국생물의학문헌수거고망락판(CBM)、중국기간전문수거고(CNKI)화중문과기기간전문수거고(유보),종지검색시간위2011년12월.수집상관문헌총결오진위섭하합관절문란병적기타질병정황,자료제취유량명검열자독립분개완성.동시,수색명위“계통평개”적총결병례보도혹병안계렬적“문헌종술”류문장,탐토대차류문장명명위“계통평개”적합이성.결과공검색도국내외문헌315편,최종납입21편(57례),균위병례보도혹림상종술.해57례피오진위섭하합관절문란병적병례분별유상합제삼마아만성관주염(43.86%)、비인암(15.79%)、합면부종류(15.97%)등20충질병,오진적원인주요유:림상표현유사(33.96%)、주소상혼효(26.43%)급인식상불족(22.64%)등.동시,검색도표위“계통평개”적병례보도류“문헌종술”문장35편,중문27편,영문8편,균결핍대병례보도진실성적평개,야몰유방법학질량평개.결론기타질병피오진위섭하합관절문란병주요발생재기림상표현겁위상사적일사질병,환자적주소용역조성혼효,의무인원전업소질흠결,공작책임심불구강역유일정관계.재명명차류총결병례보도혹병안계렬문장시,최호사용“문헌종술”,이불용“계통평개”.
Objective To summarize all the related reports to explore causes of the misdiagnoses of other diseases as temporomandibular disorder(TMD) and develop strategies in reducing the misdiagnosis, and to assess appropriateness of using“systematic review” in replace of“review” for this kind of literatures. Methods Medline (via OVID), EMBASE, Chinese BioMedical Literature Database(CBM), China National Knowledge Infrastructure (CNKI) and VIP Database for Chinese Technical Periodicals(VIP) were searched electronically till December, 2011 for identifying the case reports, case series or “systematic reviews” of misdiagnoses of other diseases as TMD. The eligible studies were selected and extracted by two independent reviewers. All the data were summa-rized to show distributions of other diseases and classifications of the possible causes of the misdiagnoses. For sec-ond aim of the study, some so-called systematic reviews on misdiagnosis in which only case reports or case series being included were also collected, to explore appropriateness of the term “systematic review” for such literatures. inoma(15.79%), different kinds of tumors(15.97%) in the orofacial region, etc. Suspected causes of the misdiagnoses could be classified into 7 categories, such as similar clinical manifestations(33.96%), confused chief complaints (26.43%), insufficient understanding of the clinicians(22.64%), etc.. Thirty five articles naming as systematic review in which case reports or case series on misdiagnoses being included were found through intensive search-ing, 8 in English and 27 in Chinese. They were narrative reviews in light of congeries of same facts without ap-praising quality of methodology or validity of the case reports or case series.“Review” should be appropriate term for such literatures and it is no need to use a modern term “systematic review” instead. The later term did not raise any new value to the term “review”. Conclusion The misdiagnoses of other diseases as TMD were mainly caused by similarities in symptoms and clinical signs of the diseases with TMD, and insufficient understandings of the clinicians. It is better to use“review” instead of“systematic review” to describe same type of the literatures.