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目的通过对24例急性白血病患儿临床特点和误诊原因的分析,提高临床医师对儿童急性白血病的认识,减少误诊率。方法收集我院2003年至2010年收治的227例急性白血病患儿的临床资料,按照其首发症状、误诊原因进行回顾性分析。结果 227例患儿中有误诊史的24例,占10.57%。误诊原因:①急性白血病首发症状多种多样,髓外侵犯多见,基层医师对本病认识不足,造成误诊;②盲目使用激素,掩盖病情,造成误诊;③不重视血涂片及骨髓检查。结论儿童急性白血病的临床表现多样化,发热及髓外病灶多见,对本病缺乏认识、盲目使用激素是误诊的首要原因,患儿临床表现特殊也是误诊的常见原因。
Objective To analyze the clinical characteristics and the causes of misdiagnosis in 24 children with acute leukemia, and to improve clinicians’ understanding of acute leukemia in children and reduce the misdiagnosis rate. Methods The clinical data of 227 cases of acute leukemia admitted from 2003 to 2010 in our hospital were collected retrospectively according to the causes of their initial symptoms and misdiagnosis. Results Among the 227 children, 24 cases were misdiagnosed, accounting for 10.57%. Causes of misdiagnosis: ① The first symptom of acute leukemia is diverse, extramedullary violations more common, grassroots doctors lack of knowledge of the disease, resulting in misdiagnosis; ② blind use of hormones to cover up the disease, resulting in misdiagnosis; ③ do not pay attention to blood smear and bone marrow examination. Conclusion The clinical manifestations of acute leukemia in children are diverse, with fever and extramedullary lesions more common. The lack of understanding of the disease and blind use of hormones are the primary causes of misdiagnosis. Children with special clinical manifestations are also a common cause of misdiagnosis.