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目的探讨结肠癌临床表现为急腹症时诊断治疗和误诊误治、漏诊漏治的原因。方法回顾性分析318例结肠癌中呈急腹症表现56例的诊断及治疗经过。结果56例结肠癌临床表现为腹内脏器急性炎症型27例,急性肠梗阻型18例,急性消化道出血型7例,急性腹内脏器穿孔型3例,急性腹内脏器缺血型1例。术前确诊33例,误诊23例均在术中快速病理切片确诊。56例术后临床治愈出院39例,好转10例,死亡7例。结论结肠癌临床表现缺乏特异性,容易误诊及漏诊,只要医生仔细询问病史及查体,借助必要的辅助检查,大多数病例术前是可以确诊的。结肠癌应尽早手术治疗。
Objective To investigate the causes of diagnosis and treatment of misdiagnosis and misdiagnosis and missed diagnosis of colon cancer with clinical manifestations of acute abdomen. Methods Retrospective analysis of 318 cases of colon cancer in acute abdomen manifestations of 56 cases of diagnosis and treatment. Results The clinical manifestations of 56 cases of colon cancer were 27 cases of acute inflammatory type of abdominal internal organs, 18 cases of acute intestinal obstruction, 7 cases of acute gastrointestinal bleeding, 3 cases of acute intra-abdominal organ perforation and 1 case of acute intra-abdominal organ ischemia . 33 cases were diagnosed preoperatively and 23 cases were misdiagnosed as fast pathological diagnosis. In the 56 cases, 39 cases were cured after operation, 10 cases improved and 7 died. Conclusion The clinical manifestations of colon cancer are lack of specificity and are easily misdiagnosed and missed. As long as the doctor carefully inquires the medical history and physical examination, most of the cases can be diagnosed preoperatively with necessary auxiliary examinations. Colon cancer should be treated as soon as possible.