妊娠滋养细胞疾病164例误诊原因分析
妊娠滋养细胞疾病；误诊原因；临床分析,,妊娠滋养细胞疾病；误诊原因；临床分析,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨分析妊娠滋养细胞疾病(GTD)误诊的原因，以求降低误诊率。方法 回顾分析1993年1月~2003年12月我院收治的487例妊娠滋养细胞疾病中的164例误诊病例。结果 11年我院共收治GTD 487例，院外、院内误诊病例共计164例，其中葡萄胎90例，侵蚀性葡萄胎44例，绒癌30例；院外误诊率23.61%，院内误诊率10.04%；分析原因，其中临床思维方法不恰当占40.71%，居首位，其次为病史不详、查体不全占19.32%，第三位为症状、体征不典型占18.91%，临床思维方法不恰当所占比例明显高于其他因素，差异有显著性(P<0.05)；误诊为早孕、先兆流产114例(69.5%)、功能失调性子宫出血12例(7.3%)、葡萄胎21例(12.8%)、异位妊娠6例(3.7%)。结论 临床医师应掌握科学的临床思维方法，正确认识疾病的本质，减少误诊；重视葡萄胎的随访，严密监测GTD患者β-HCG水平变化。【关键词】 妊娠滋养细胞疾病；误诊原因；临床分析
Analysis on the misdiagnostic reasons of 164 gestational trophoblastic disease cases
YAN Jianying,CUI Xiaomei,CHEN Wenzhen.Department of Obstetrics and Gynecology,Fujian Maternity and Child Care Hospital,Fuzhou 350001,China
【Abstract】 Objective To analyze the misdiagnostic reasons of gestational trophoblastic disease(GTD) cases to reduce the misdiagnostic rate.Methods Retrospective study on 164 misdiagnostic cases of GTD in all 487 GTD cases in our hospital in 1993.1~2003.12 were performed.Results 164 cases included 90 cases of mole, 44 cases of invasive mole, 30 cases of choriocarcinoma.The out-of-hospital misdiagnostic rate was 23.57%; in-hospital misdiagnostic rate was 10.04%.Among the misdiagnostic reasons, unsuitable clinical thinking took the first place (40.71%), the second one was incomplete medical record and examination (19.32%), the third one was because of untypical symptoms and signs.The rate of unsuitable clinical thinking was higher than others distinctly (P<0.05).114 cases were misdiagnosed as early pregnancy and threatened abortion (69.5%), 12 cases were misdiagnosed as dysfunctional uterine bleeding (7.3%), 21 cases were misdiagnosed as mole (12.8%), 6 cases as ectopic pregnancy (3.7%).Conclusion Using a scientific clinical thinking and understanding the essence of the disease can reduce the misdiagnosis. We should emphasize the visit of the mole patients and the monitor of the GTD patients’ serum β-HCG level. ......
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