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目的:探讨结肠癌误诊为阑尾炎的原因及预防措施。方法:2003/2007年我院共收治结肠癌误诊为阑尾炎患者31例,所有患者均行手术治疗并经病理检查证实诊断。结果:31例误诊为急性阑尾炎,27例急诊行阑尾切除术。14例术中发现升结肠癌行根治性手术。13例仅行阑尾切除,术后均引出现消化道症状而复诊,平均出现症状时间46 d。4例误诊为阑尾周围脓肿,因反复出现症状行钡灌肠检查明确结肠癌的诊断。结论:病史采集不详细、思维惯性的影响、以及术中切口选择不当是结肠癌误诊为阑尾炎的主要原因。加强病史的询问,完善必要的辅助检查,可以有效地减少误诊的发生。
Objective: To investigate the causes and preventive measures of misdiagnosed colon cancer as appendicitis. Methods: In our hospital from 2003 to 2007, 31 cases of colon cancer were misdiagnosed as appendicitis. All patients underwent surgical treatment and confirmed by pathological examination. Results: 31 cases were misdiagnosed as acute appendicitis and 27 cases were performed appendectomy. In 14 cases of ascending colon cancer found radical surgery. 13 cases only appendectomy, gastrointestinal symptoms were cited after referral, the average symptom onset time 46 d. 4 cases misdiagnosed as appendectomy around the abdomen, due to recurrent symptoms of barium enema to confirm the diagnosis of colon cancer. Conclusion: The lack of detailed medical history, the impact of thinking inertia, as well as inappropriate choice of incision in colon cancer misdiagnosed as appendicitis main reason. Strengthen the history of the inquiry, improve the necessary auxiliary examination, can effectively reduce the incidence of misdiagnosis.