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目的分析临床中对脑性瘫痪(脑瘫)的误诊、漏诊及过度诊断情况。方法对1999年7月～2010年3月住院或门诊患儿中首诊时与脑瘫的误诊、漏诊及过度诊断有关的389例患儿进行回顾性分析。结果 389例患儿中,156例脑瘫患儿漏诊或误诊为营养性疾病,118例其他疾病患儿误诊为脑瘫,115例正常儿过度诊断为脑瘫;错误诊断情况与其年龄有相关性:年龄越小,越容易出现诊断错误,其中1岁以内婴儿错误诊断293例(75.3%);2004年9月之前漏诊或误诊为其他疾病者较多,为102例(65.4%),2004年9月之后以过度诊断较多,为87例(75.7%),其他疾病误诊为脑瘫在2004年以后有所减少,从55.9%降至44.1%。结论提高对脑瘫的认识,正确掌握脑瘫的诊断标准非常重要。既要做到对脑瘫的早期诊断、早期治疗,以达到最佳的康复疗效,又要防止误诊及过度诊断,以致延误病情或浪费医疗资源、增加患儿家庭经济负担及心理负担。
Objective To analyze the misdiagnosis, misdiagnosis and over-diagnosis of cerebral palsy (cerebral palsy) in clinic. Methods A retrospective analysis was performed on 389 children with misdiagnosis, missed diagnosis and overexpression of cerebral palsy at the first visit from July 1999 to March 2010 in hospitalized children or outpatients. The results of 389 cases of children in 156 cases of children with cerebral palsy missed or misdiagnosed as nutritional diseases, 118 cases of other diseases in children misdiagnosed as cerebral palsy, 115 cases of excessive normal children diagnosed with cerebral palsy; error of diagnosis correlated to their age: the age of the Small, more prone to diagnostic errors, of which infants within 1 year of age, false diagnosis of 293 cases (75.3%); before September 2004 missed or misdiagnosed as other diseases were more, 102 cases (65.4%), after September 2004 To over diagnose, 87 cases (75.7%), other diseases misdiagnosed as cerebral palsy after 2004 decreased from 55.9% to 44.1%. Conclusion To improve the understanding of cerebral palsy, it is very important to correctly understand the diagnostic criteria of cerebral palsy. It is necessary to achieve early diagnosis and early treatment of cerebral palsy in order to achieve the best rehabilitation effect, but also to prevent misdiagnosis and over-diagnosis, resulting in the delay of medical conditions or waste of resources to increase the economic burden and psychological burden on children’s families.