摘要
目的:了解我国耳鼻咽喉疾病的临床误诊概况,为减少误诊、提高诊断水平提供参考依据。方法:利用误诊疾病数据库检索与管理系统对数据库已收录的2004-2013年误诊文献数据中所有耳鼻咽喉疾病文献进行统计学分析,包括文献来源、样本量、误诊率、误诊范围、误诊后果、误诊原因等。结果:共命中文献369篇,累计误诊病例4 211例。共51种确诊疾病,平均误诊率为25.43%,误诊率最高为鼻咽结核(84.76%)、结核性中耳炎(75.00%)、先天性喉囊肿(75.00%),最低为鼻窦炎(5.92%)。误诊病例数最高的前3位疾病依次为鼻咽喉结核(1 216例)、鼻-鼻窦炎(710例)和良性阵发性位置性眩晕(697例)。对误诊后果的统计显示,97.22%的患者为Ⅲ级误诊后果,即发生误诊误治未造成不良后果,但仍有10例造成Ⅰ级后果(死亡或后遗症)。对文献中误诊原因频次进行统计,居前3位的依次为经验不足缺乏对该病的认识,问诊及体检不细致和未选择针对性检查措施。结论:10年误诊大数据结果在一定程度上反映了我国耳鼻咽喉疾病的误诊现象,耳鼻咽喉科和神经科、口腔科、呼吸科及眼科医生都应了解容易误诊的耳鼻咽喉疾病的鉴别诊断要点,力求减少临床误诊误治。
Objective：The aim of this study is to explore the misdiagnosis status of the otolaryngology in China as well as to provide evidence to reduce misdiagnosis and improve the diagnostic level.Method：The retrieval and management system of the misdiagnosed diseases database developed by Chen Xiaohong was used for searching the literature of the misdiagnosis in otolaryngology.The 10years＇ misdiagnosis literature data of the otolaryngology（from 2004 to 2013）were analyzed including the literature sources,sample size,misdiagnosis rate,misdiagnosis consequences and misdiagnosis reasons.Result：A total of 369 articles were found,including 4 211 cases.The average misdiagnosis rate was 25.43%in 51 diagnosed diseases.The top misdiagnosed diseases were nasopharyngeal tuberculosis（84.76%）,tuberculous otitis media（75%）and congenital laryngeal cyst（75%）.The lowest misdiagnosed disease was nasosinusitis（5.92%）.The top three misdiagnosed diseases were tuberculosis of otolaryngology（1 216cases）,nasosinusitis（710cases）and BPPV（697cases）.After statistical analysis,we found that 97.22%of the misdiagnosed patients were gradeⅢconsequences（that is the misdiagnosis and mistreatment does not cause adverse consequences）,but there were still 10 cases caused gradeⅠconsequences（death or sequela）.The main causes of the misdiagnosis were lack of diagnosis experience,non detailed interrogation and physical examination and non targeted examinations.Conclusion：The big data of the 10 years reflects the misdiagnosis phenomenon in otolaryngology to some extent.Neurologist,stomatologist and ophthalmologist should be familiar to the main points of the differential diagnosis diseases of the otolaryngology and strive to reduce the clinical misdiagnosis and mistreatment.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2016年第15期1195-1200,共6页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻疾病
耳疾病
咽疾病
喉疾病
误诊
nose diseases
ear diseases
pharyngeal diseases
laryngeal diseases
diagnostic errors
