中国继续医学教育
中國繼續醫學教育
중국계속의학교육
CHINA CONTINUING MEDICAL EDUCATION
2015年
20期
141-142
,共2页
亚急性甲状腺炎%误诊%分析
亞急性甲狀腺炎%誤診%分析
아급성갑상선염%오진%분석
Subacute thyroiditis%Misdiagnose%Analysis
目的：探讨基层医院亚急性甲状腺炎误诊的常见原因，以及减少误诊的应对策略。方法回顾性分析2011年4月～2013年12月诊治的21例亚急性甲状腺炎误诊患者临床资料，总结误诊原因及预防措施。结果误诊以上呼吸道感染、咽炎、颌下淋巴结炎、桥本甲状腺炎等常见病为主，主要原因为基层医师对本病缺乏认识，诊断性思维局限，对病史询问及查体不够仔细，忽略甲状腺检查。21例患者均经T3、T4、甲状腺131I吸收率以及彩色多普勒检查确诊。结论亚急性甲状腺炎早期症状不典型，不同分期临床表现呈多样性，基层医院医生对其认识不足，易于误诊。基层医生应提高对本病的认识水平，对疑似患者及时行血沉、T3、T4及甲状腺131I吸收率检查，必要时行细针穿刺细胞学检查，或诊断性糖皮质激素治疗。
目的：探討基層醫院亞急性甲狀腺炎誤診的常見原因，以及減少誤診的應對策略。方法迴顧性分析2011年4月～2013年12月診治的21例亞急性甲狀腺炎誤診患者臨床資料，總結誤診原因及預防措施。結果誤診以上呼吸道感染、嚥炎、頜下淋巴結炎、橋本甲狀腺炎等常見病為主，主要原因為基層醫師對本病缺乏認識，診斷性思維跼限，對病史詢問及查體不夠仔細，忽略甲狀腺檢查。21例患者均經T3、T4、甲狀腺131I吸收率以及綵色多普勒檢查確診。結論亞急性甲狀腺炎早期癥狀不典型，不同分期臨床錶現呈多樣性，基層醫院醫生對其認識不足，易于誤診。基層醫生應提高對本病的認識水平，對疑似患者及時行血沉、T3、T4及甲狀腺131I吸收率檢查，必要時行細針穿刺細胞學檢查，或診斷性糖皮質激素治療。
목적：탐토기층의원아급성갑상선염오진적상견원인，이급감소오진적응대책략。방법회고성분석2011년4월～2013년12월진치적21례아급성갑상선염오진환자림상자료，총결오진원인급예방조시。결과오진이상호흡도감염、인염、합하림파결염、교본갑상선염등상견병위주，주요원인위기층의사대본병결핍인식，진단성사유국한，대병사순문급사체불구자세，홀략갑상선검사。21례환자균경T3、T4、갑상선131I흡수솔이급채색다보륵검사학진。결론아급성갑상선염조기증상불전형，불동분기림상표현정다양성，기층의원의생대기인식불족，역우오진。기층의생응제고대본병적인식수평，대의사환자급시행혈침、T3、T4급갑상선131I흡수솔검사，필요시행세침천자세포학검사，혹진단성당피질격소치료。
Objective To explore the common causes of subacute thyroiditis misdiagnosis and the coping strategies to reduce misdiagnose in primary hospitals. Methods Retrospectively were analyzed on the data of 21 patients with subacute thyroiditis who were misdiagnosed from April 2011 to December 2013 and the reasons of misdiagnosis were analysised and summaried. Results Most of the patients were diagnosed as respiratory tract infection, pharyngitis, submaxillary lymph nodes, hashimoto thyroiditis and other common diseases, the primary causes leaded to this result were the physicians in primary hospitals were short of knowledge on this disease, their diagnostic thinking limitations, didn’t carefully inquire the patients’ medical history and take physical examination on them and lost sight of thyroid examination. All of the 21 patients were made a deifnite diagnosis through the T3, T4, thyroid 131I absorptivity examination and color doppler examination. Conclusion The early symptoms of subacute thyroiditis are atypical, the clinical manifestations are multifarious in different stages, the physicians in primary hospitals are short of knowledge on this disease, they are apt to misdiagnose. The physicians in primary hospitals should enhance their knowledge on this disease;examine the suspected patients through erythrocyte sedimentation rate, T3, T4, and thyroid 131I absorptivity examination in time, when it is in necessity, take ifne needle aspiration cytological examination or diagnostic glucocorticoid treatment.
