误诊疾病数据库2004—2013年单病种误诊文献研究:颅内静脉窦血栓形成

发布时间：2018-04-02 20:52

本文选题：窦血栓形成　切入点：颅内　出处：《临床误诊误治》2016年04期

【摘要】：颅内静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)临床表现各异,体征不典型且多变,随着诊断技术及临床重视程度的提高,本病检出率逐渐升高,但误诊率仍较高。2004—2013年发表在中文医学期刊并经遴选纳入误诊疾病数据库的CVST文献共95篇,累计误诊病例674例,涉及误诊率文献29篇654例,误诊例数284例,误诊率43.43%。误诊范围涉及53种疾病,其中前4位误诊疾病是脑梗死、蛛网膜下腔出血、中枢神经系统感染、病毒性脑炎。主要误诊原因为经验不足而缺乏对该病的认识、缺乏特异性症状体征和未选择特异性检查项目。共438例误诊病例描述了误诊与疾病转归的关联,其中382例(87.21%)未因误诊误治造成不良后果。提示临床医师应提高对CVST的认识,对头痛、呕吐、颅内压升高、视力丧失者应考虑本病可能,及时行头颅磁共振血管成像和数字减影血管造影检查并仔细鉴别诊断,以减少误诊的发生。
[Abstract]:The clinical manifestations of cerebral venous sinus thromboembolism (CVST) are different, the signs are atypical and changeable. With the improvement of diagnostic technique and clinical importance, the detection rate of CVSTs increases gradually.However, the misdiagnosis rate was still high. 95 CVST papers published in Chinese medical journals from 2004 to 2013 were selected and included in the misdiagnosis database. The total misdiagnosis rate was 674, the misdiagnosis rate was 29 articles, the misdiagnosis rate was 284 cases, and the misdiagnosis rate was 43.43%.The misdiagnosis scope involved 53 diseases, among which the first 4 misdiagnosed diseases were cerebral infarction, subarachnoid hemorrhage, central nervous system infection and viral encephalitis.The main causes of misdiagnosis were inexperience and lack of understanding of the disease, lack of specific symptoms and signs and lack of selection of specific examination items.A total of 438 misdiagnosed cases described the relationship between misdiagnosis and the outcome of the disease, among which 382 cases (87.21) did not have adverse consequences due to misdiagnosis and mistreatment.It is suggested that the clinicians should improve their understanding of CVST, and should consider the possibility of this disease in patients with headache, vomiting, elevated intracranial pressure and visual loss, and make a prompt examination of head magnetic resonance angiography and digital subtraction angiography, and make careful differential diagnosis.In order to reduce the incidence of misdiagnosis.
【作者单位】：沈阳军区总医院神经内科;
【基金】：辽宁省科技攻关计划(2013225089;2014225008)
【分类号】：R743.33

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