摘要
目的探讨多发性骨髓瘤(multiple myeloma,MM)的临床特点、误诊原因及防范误诊措施。方法对误诊疾病数据库2004—2013年收录的关于MM误诊的相关文献进行回顾性分析。结果共纳入231篇文献3230例误诊病例,其中涉及误诊率文献70篇,误诊例数1929例,误诊率55.13%。误诊疾病达131种,涉及16个系统或专科,以运动系统和泌尿系统疾病居多,前3位误诊疾病为肾炎、肾功能不全、骨质疏松症。经验不足而缺乏对该病的认识、未选择特异性检查项目和诊断思维方法有误为主要误诊原因。误诊均导致病情迁延或不良后果。结论 MM由于临床表现的系统性和非特异性,易误诊;熟知其临床和特异性医技检查特点及诊断标准,运用正确的临床思维,可提高本病诊断准确率。
Objective To investigate the clinical characteristics of multiple myeloma （MM） , causes of misdiagnosis and preventive measures. Methods MM misdiagnosis database from 2004 to 2013 was retrospectively analyzed. Results A total of 231 literatures including misdiagnosis 3230 cases with MM were included, involving in the misdiagnosis rate of 70 liter-atures, and 1929 cases were misdiagnosed. The misdiagnosis rate was 55. 13%. Misdiagnosed diseases reached 131 kinds, related to 16 systems or specialists; majority of them was related to exercise system and urinary system. The top 3 diseases were misdiagnosed as nephritis, renal insufficiency and osteoporosis. The lack of experience and awareness of MM, not choo- sing specific laboratory examinations and mistakes of diagnostic thoughts were the main causes of misdiagnosis. The misdiagnosis was lead to persistent disease or adverse consequences. Conclusion Due to systemic and nonspecific clinical manifesta- tions, the Misdiagnosis of MM is very easy ; familiar with its clinical and laboratory features, grasping its diagnostic criteria, and application of the correct clinical thinking can improve the accuracy of the diagnosis of this disease.
作者
曾敏
羊裔明
ZENG Min YANG Yi-ming(Department of Hematology, Shifang City People＇s Hospital, Sichuan 618400, China Department of Hematology, Laboratory of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China)
出处
《临床误诊误治》
2017年第1期31-35,共5页
Clinical Misdiagnosis & Mistherapy
关键词
多发性骨髓瘤
误诊
肾炎
数据库
数据说明
统计
Multiple myeloma
Misdiagnosis
Nephritis
Database
Data interpretation, statistical
