我国炎症性肠病漏诊和误诊的近况及对策
多肉名字摘要桌面壁纸高清全屏
漫漫征途目的：炎症性肠病（inflammatory bowel dia, IBD）在我国的发病率逐年提高，但由于缺乏特异性的临床表现和检查手段，漏诊和误诊率较高。历年来有过许多有关IBD漏诊和误诊的病例报道，但尚无较为系统完整的病例汇总及漏诊和误诊的情况分析。本研究旨在通过对IBD临床研究文献的搜集，汇总出容易引起IBD漏诊和误诊的病种，探讨有效的鉴别方法，给临床正确诊断IBD提供一定的参考依据。
额头凹陷面相>友情诗方法：分别以炎症性肠病（inflammatory bowel dia, IBD）、溃疡性结肠炎(Ulcerative colitis, UC）和克罗恩病(Crohn’s dia, CD）为主题词，利用计算机检索1989年1月至2008年12月万方期刊库、中国科技期刊全文数据库、中国生物医学文摘数据库所报道的相关文献，逐篇查阅原文，统计IBD漏诊和误诊的病例数及病种，汇总分析其产生的原因，并探讨相应的对策。
结果：共检出572篇有关IBD漏诊或误诊的临床研究文献，其中UC176篇，总病例数为3053例，漏诊912例，漏诊率29.9%，主要漏诊病种为细菌性痢疾、不明原因的慢性腹泻和内痔，误诊221例，误诊率
7.2%，主要误诊病种为细菌性痢疾、肠易激综合征、缺血性肠病；CD356篇，总病例数为3703例，其中漏诊2647例，漏诊率48.6%，主要漏诊病种为肠结核、急性阑尾炎和肠道肿瘤，误诊627例，误诊率16.9%，主要误诊病种为肠结核、小肠淋巴瘤和结肠肿瘤。
攒动的意思
结论：我国IBD的病例数逐年上升，患病的男女比例无明显差异。CD的误诊和漏诊率比UC更高。UC最易与细菌性痢疾相互误诊；CD 最易与肠结核相互误诊。唯有结合详细病史、临床表现、体格检查和各项辅助检查手段综合判断，才能减少漏诊误诊发生率。
关键词：炎症性肠病，溃疡性结肠炎，克罗恩病，漏诊，误诊
AN ANALYSIS OF MISSED DIAGNOSE AND
MISDIAGNOSE IN INFLAMMATORY BOWEL
DISEASE IN CHINA
回收相机
ABSTRACT
水成语接龙OBJECTIVE: Inflammatory bowel dia(IBD) was considered as uncommon in China in the past. However, some rearches indicate that the number of IBD patients and articles in literatures have been increasing in China the years. In order to improve the diagnostic level of IBD, the relevant literatures with IBD in China were reviewed and the caus of misd and misdiagnosis about IBD were analyzed.
METHODS: Papers on IBD published in medical journals from 1989 to 2008 in Wanfang Dateba, China Biological Mediciine Disc(CBMDisc), Chine scientific and technical periodical databa were collected and reviewed one by one. “Inflammatory bowel dia” or “ulcerative colitis (UC)” or “Crohn’s dia(CD)” were chon as major theme-words. All studies concerned were pooled and weighted, and then the characteristics of
the misd and misdiagnod IBD were recorded and the caus of the cas were analyzed.
RESULTS: 572 articles related to IBD published in recent 20 years were obtained, of which 176 papers with 3053 cas were UC, 356 papers with 3703 cas were CD. In the 3053 UC cas, 912 cas were misd diagnod, and the most common misd diagnod dias were bacterial dyntery, chronic diarrhea of unknown origin and hemorrhoids; 221 cas were misdiagnod, and the most common were bacterial dyntery, irritable bowel dia and ischemic colitis. In the 3703 CD cas, 2647 cas were misd diagnod, and the most common misd diagnod dias were intestinal tuberculosis, acute appendicitis and intestinal cancer; 627 cas were misdiagnod, and the most common misdiagnod dias were intestinal tuberculosis, intestinal lymphoma and intestinal cancer.
CONCLUSION: The number of IBD patients have been increasing progressively in China in recent 20 years, and there was no obvious distinction between the two genders in the patients. The most common misd and misdiagnod dia with UC was bacterial dyntery, the most common misd and misdiagnod dia with CD was intestinal tuberculosis. CD had a higher misd and misdiagnod rate than UC. Only
by the combination of intimate ca history, clinical manifestation, physical examination and all kinds of tests can we decrea the misd and misdiagno rate of IBD.
KEY WORDS: inflammatory bowel dia, ulcerative colitis,Crohn’s dia, misd and misdiagno
