摘要
目的分析门、急诊医师对儿童神经母细胞瘤的早期识别现状。方法回顾性分析2016年1月~2019年12月本院收治的经病理确诊为神经母细胞瘤患儿29例的临床表现、误诊病种等。比较门、急诊内、外科医师的误诊差异。比较彩色多普勒超声与CT检查对儿童神经母细胞瘤的检出率差异。结果神经母细胞瘤临床症状多样,首发症状以胃肠道症状(33.33%)、发热(22.22%)、骨痛(18.52%)、肌痛(7.41%)多见,在本研究中容易被误诊为慢性腹泻病(25.00%)。门、急诊内科误诊率(94.44%)与外科误诊率(27.27%)比较,差异有统计学意义(P<0.01),儿内科医师误诊率高(94.44%)。彩色多普勒超声检出率(96.15%)与CT检出率(100.00%)比较,差异无统计学意义(P>0.05)。结论儿内科医师误诊率高,应提高对神经母细胞瘤的认识,同时对可疑病例及时进行超声筛查。
Objective To analyze the current situation of early recognition of children neuroblastoma by physicians and surgeons in outpatient and emergency departments.Methods The clinical manifestations and misdiagnosed diseases of neuroblastoma confirmed by pathology in 29 cases admitted to our hospital from January 2016 to December 2019 were retrospectively analyzed.Whether there was any difference in misdiagnosis between physicians and surgeons in outpatient and emergency departments was analyzed.The difference in the detection rate of children neuroblastoma between color Doppler ultrasonography and CT was compared.Results Neuroblastoma has various clinical symptoms,and the first symptoms are commonly gastrointestinal symptoms(33.33%),fever(22.22%),bone pain(18.52%),and myalgia(7.41%).In this study,neuroblastoma was easily misdiagnosed as chronic diarrhea(25.00%).The misdiagnosis rates of physicians and surgeons in outpatient and emergency departments were 94.44%and 27.27%,respectively,with statistically significant differences(P<0.01),and the misdiagnosis rate of pediatric physicians was high(94.44%).There was no difference in the detection rate between color Doppler ultrasonography(96.15%)and CT(100.00%)(P>0.05).Conclusion Pediatric physicians have a high misdiagnosis rate,so they should improve understanding of neuroblastoma.At the same time,a timely ultrasonic screening should be conducted for suspected cases.
作者
隋晓东
SUI Xiaodong(Emergency Department,Xiamen Children's Hospital,Xiamen 361006,China)
出处
《中国现代医生》
2020年第34期18-22,F0003,共6页
China Modern Doctor
关键词
儿童神经母细胞瘤
临床表现
临床误诊
辅助检查
Children neuroblastoma
Clinical manifestations
Clinical misdiagnosis
Auxiliary examinations
