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目的 探讨原发性胆管细胞性肝癌的误诊误治情况及其原因 ,以及避免误诊误治的方法。方法 对我院经病理学检查证实 40例原发性胆管细胞性肝癌的诊断和治疗情况进行调查和统计分析 ,了解误诊误治情况及易误诊的疾病。结果 首次就诊的误诊率为 6 8% ,所误诊的疾病依次为胆石症伴肝内炎症包块 ,肝脓疡、肝囊肿、肝腺瘤。施行误治的有 :胆管探查取石术、肝脓疡切开引流术或B型超声引导下穿刺抽吸引流术 ,肝囊肿开窗引流术、肝囊肿切除术。结论 原发性胆管细胞性肝癌误诊率高 ,且常被误诊。避免误诊的方法有 :(1)注意寻找本病的特征性表现 ;(2 )提倡所有肝内占位术前、术中活体组织学检查是避免误漏诊的重要方法。
Objective To investigate the misdiagnosis and mistreatment of primary cholangiocarcinoma and its causes, and to avoid misdiagnosis and mistreatment. Methods The pathological examination in our hospital confirmed the diagnosis and treatment of 40 cases of primary cholangiocarcinoma. The investigation and statistical analysis were conducted to understand the misdiagnosis and misdiagnosis and the misdiagnosis diseases. Results The misdiagnosis rate of the first visit was 68%. The misdiagnosis was cholelithiasis with intrahepatic inflammation, liver abscess, hepatic cyst, and hepatic adenoma. Mistreatments were performed: bile duct exploration and lithotripsy, hepatic abscess incision and drainage or B-ultrasound guided puncture and aspiration, hepatic cyst drainage, hepatic cyst resection. Conclusion The misdiagnosis rate of primary cholangiocarcinoma is high and often misdiagnosed. The methods of avoiding misdiagnosis include: (1) Pay attention to the characteristic performance of the disease; (2) Advocate the preoperative and intraoperative biopsy of all intrahepatic occupants is an important method to avoid misdiagnosis.