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目的探讨结肠癌的误诊原因及预防方法。方法回顾性分析2007年1月至2012年11月肇庆市第二人民医院普外科收治的218例结肠癌中存在误诊的49例患者的资料。结果 49例结肠癌在结肠镜检查或手术明确诊断前存在误诊。误诊为慢性结肠炎21例,盆腔炎12例,痔疮8例,胃炎及缺铁性贫血5例,结肠息肉4例,慢性阑尾炎2例,肠梗阻1例。其中4例患者存在二次误诊。病理类型:管状腺癌18例,乳头状腺癌17例,黏液腺癌13例,未分化癌1例。按Dukes分期,无A期病例,B期10例,C期35例,D期4例。结论对有大便习惯与粪便性状改变、内科治疗效果不佳的患者要考虑结肠癌的可能,尽早行结肠镜检查,而检查阴性但临床上仍怀疑的患者应重复检查,避免漏诊。
Objective To investigate the causes and prevention of misdiagnosis of colon cancer. Methods The data of 49 patients with misdiagnosis in 218 cases of colon cancer admitted to General Surgery, Second People ’s Hospital, Zhaoqing from January 2007 to November 2012 were retrospectively analyzed. Results 49 cases of colon cancer misdiagnosis before colonoscopy or surgery. Misdiagnosed as chronic colitis in 21 cases, pelvic inflammatory disease in 12 cases, hemorrhoids in 8 cases, gastritis and iron deficiency anemia in 5 cases, 4 cases of colonic polyps, chronic appendicitis in 2 cases, intestinal obstruction in 1 case. Four patients were misdiagnosed twice. Pathological types: 18 cases of tubular adenocarcinoma, 17 cases of papillary adenocarcinoma, mucinous adenocarcinoma in 13 cases, 1 case of undifferentiated carcinoma. According to Dukes staging, no A cases, B in 10 cases, C in 35 cases, D in 4 cases. Conclusion Patients with bowel habits and fecal changes and poor medical treatment should consider colon cancer as soon as possible and colonoscopies should be conducted as soon as possible. Patients who are negative but clinically suspicious should be repeatedly examined to avoid missed diagnosis.