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目的:探讨鼻咽癌延误诊断的原因。从而提高鼻咽癌患者的早期诊断率,改善治疗效果。方法:回顾性分析324例在我科接诊前因各种因素而延误诊断的鼻咽癌患者首发症状、首诊误诊科室、误诊疾病。结果:本组病例首发症状分别为颈部包块138例(42.5%)、鼻部症状148例(45.6%)、耳部症状66例(20.3%)、头痛46例(14.2%)、其他17例(5.2%),有两种首发症状的病例为91例。首诊误诊的疾病有颈部淋巴结炎、慢性鼻-鼻窦炎、鼻出血、分泌性中耳炎、脑动脉硬化等27种疾病。涉及普外科、耳鼻咽喉科、神经内科、骨科、呼吸内科、口腔科、烧伤科、眼科、中医科等9个科室。结论:加强鼻咽癌知识普及,完善继续医学教育及住院医师培训,积极寻找鼻咽癌的早期诊断方法能减少鼻咽癌的延误诊断。
Objective: To investigate the causes of delayed diagnosis of nasopharyngeal carcinoma. So as to improve the early diagnosis rate of nasopharyngeal carcinoma patients and improve the therapeutic effect. Methods: A retrospective analysis of 324 cases of nasopharyngeal cancer patients with delayed diagnosis due to various factors in our department before the first symptoms, the first diagnosis of misdiagnosis departments, misdiagnosis of the disease. Results: The first symptom of this group were 138 cases (42.5%) of the cervical mass, 148 cases (45.6%) of the nasal symptoms, 66 cases (20.3%) of the ear symptoms, 46 cases (14.2%) of the headache and 17 Cases (5.2%), there are two cases of first symptom in 91 cases. The first diagnosis of misdiagnosed diseases are cervical lymphadenitis, chronic rhinosinusitis, epistaxis, otitis media, cerebral arteriosclerosis and other 27 kinds of diseases. Involved in general surgery, otolaryngology, neurology, orthopedics, respiratory medicine, stomatology, burns, ophthalmology, Chinese medicine and other nine departments. Conclusion: Enhancing the popularization of knowledge of nasopharyngeal carcinoma, improving the training of continuing medical education and residency, and actively searching for the early diagnosis of nasopharyngeal carcinoma can reduce the delay diagnosis of nasopharyngeal carcinoma.