多发性骨髓瘤的临床误诊分析(1)
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【摘要】 目的 探讨多发性骨髓瘤的临床误诊并进行分析。方法 回顾我科2004年1月至2009年12月收治的多发性骨髓瘤571例。其中发生误诊病例326例,进行总结分析。结果 误诊率达57.09%,误诊为骨关节、肌肉类疾病117例,占35.88%;血液系统疾病48例,占14.72%;泌尿系统疾病66例,占20.24%;感染性疾病31例,占9.50%;循环系统疾病18例,占5.52%;消化系统疾病22例,占6.74%;神经系统疾病12例,占3.68%;皮肤类疾病4例,占1.22%;自身免疫性疾病8例,占2.45%。结论 多发性骨髓瘤因起病隐匿,病程缓慢,症状不典型,多样化、复杂化的临床表现和多发性骨髓瘤骨髓瘤细胞往往分布不均,有些患者需经过多次、多部位骨穿才能明确。加之医生缺乏对多发性骨髓瘤的认识,医生对实验室检查结果不能正确分析。对该病警惕性不高,仅满足于首发症状,或某一突出表现,并未进行全面细致的询问病史,系统的检查未能对多系统损害进行综合分析是造成误诊的多方面因素。
【关键词】多发性骨髓瘤;误诊;临床分析
Clinical misdiagnosis analysis of Multiple myeloma
WANG Gen jie.
Blood branch of first People’s Hospital in Shangqiu,Henan,Shangqiu 476100,China
【Abstract】 Objective To investigate the clinical misdiagnosis of multiple myeloma and analyzed.Methods Review our department from January 2004 to December 2,009 year admitted 571 cases of multiple myeloma.Misdiagnosed cases of which 326 cases occurred,were analyzed.Results The misdiagnosis rate was 57.09%,misdiagnosed as bone and joint,muscle diseases in 117 cases,accounting for 35.88%; 48 cases of blood diseases,accounting for 14.72%; 66 cases of urinary system diseases,accounting for 20.24%; 31 cases of infectious diseases,accounting for 9.50%; circulatory diseases in 18 cases,accounting for 5.52%; 22 cases of digestive diseases,accounting for 6.74%; nervous system diseases,12 cases,accounting for 3.68%; four cases of skin diseases,accounting for 1.22%; 8 cases of autoimmune diseases,accounted for 2.45%.Conclusion The onset of multiple myeloma because of hiding,the slow course of the disease,symptoms are not typical,diverse and complex clinical manifestations and bone marrow of multiple myeloma tumor cells are often distributed unevenly,and some patients had repeated,multi site Guchuan be clear.Combined with the lack of medical awareness of multiple myeloma,the doctor of laboratory test results can not be correctly analyzed.Vigilance against the disease is not high,only to be satisfied with the first symptom,or an outstanding performance has not been asked to conduct a comprehensive and detailed medical history,the system checks failed to conduct a comprehensive analysis of multi system damage is caused by various factors of misdiagnosis ......
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