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目的：分析急性胰腺炎（ＡＰ）误诊误治的原因。方法：对近５年来我院收治的１１２８例ＡＰ病人中误诊误治的１３２例进行回顾性总结与分析。结果：总误诊率为１１７％，主要误诊为急性胃肠炎４３例（３２５８％），胆系疾病３８例（２８７９％），肠梗阻１４例（１０６１％），胃肠穿孔１０例（７５％），阑尾炎９例（６８２％），黄疸型肝炎６例（４５５％），妊娠并发症６例（４５５％），间质型ＡＰ误诊为坏死型手术１０例（７５８％），胰腺癌３例（２２７％），左肾结石２例（１５２％）。误诊时未查血尿ＡＭＹ９７例，未查Ｂ超８０例。最后确诊依据为动态检查血尿ＡＭＹ升高１０３例，腹水ＡＭＹ升高４９例，Ｂ超诊断８９例，ＣＴ诊断６６例，手术确诊５８例。结论：对ＡＰ发病诱因重视不够；满足于原有疾病的诊断；对全腹膜缺乏全面分析；过分依赖辅助检查是主要误诊原因，并指出了误诊的后果以及减少误诊的具体措施。
Objective: To analyze the causes of misdiagnosis and mistreatment of acute pancreatitis (AP). Methods: 132 cases of misdiagnosis and mistreatment in 1128 AP patients admitted to our hospital in the past 5 years were retrospectively reviewed and analyzed. Results: The total misdiagnosis rate was 117%, mainly misdiagnosed as 43 cases (3258%) of acute gastroenteritis, 38 cases (2879%) of biliary diseases, 14 cases (1061%) of intestinal obstruction, Gastrointestinal perforation in 10 cases (75%), appendicitis in 9 cases (682%), jaundice hepatitis in 6 cases (455%), pregnancy complications in 6 cases (455%), interstitial AP Misdiagnosed as necrotic surgery in 10 cases (758%), pancreatic cancer in 3 cases (227%), left kidney stone in 2 cases (152%). Misdiagnosis did not check the hematuria AMY97 cases, did not check B-80 cases. The final diagnosis based on the dynamic examination of hematuria AMY increased 103 cases, ascites AMY increased 49 cases, B ultrasound diagnosis of 89 cases, CT diagnosis of 66 cases, 58 cases of surgical diagnosis. CONCLUSIONS: Insufficient attention is paid to the causes of AP; the diagnosis of the original disease is satisfied; the full peritoneum is not fully analyzed; and the over-dependence of the auxiliary examination is the main cause of misdiagnosis. The misdiagnosis and the specific measures to reduce misdiagnosis are pointed out.