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目的探讨妊娠滋养细胞疾病误诊的情况和原因,为妊娠滋养细胞疾病的鉴别诊断提供依据。方法选取2006年1月-2014年1月该院收治的妊娠滋养细胞疾病患者86例,其中25例初次诊断误诊为其他疾病。统计患者被误诊的疾病情况并分析妊娠滋养细胞疾病误诊的原因。结果总体误诊率为29.07%,其中被误诊为功能失调性子宫出血的患者比例为6.98%,被误诊为子宫内膜修复不全的患者比例为5.81%,被误诊为不完全流产的患者比例为5.81%,被误诊为异位妊娠的患者比例为4.65%,被误诊为肺结核的患者比例为3.49%,被误诊为骨肉瘤的患者比例为2.33%,被误诊的疾病比例间比较差异有统计学意义(P<0.05)。单因素分析结果显示,妊娠滋养细胞疾病误诊的原因包括年龄、流产史、妊娠史、转移和癌病史等。多因素分析结果显示,妊娠滋养细胞疾病误诊原因的包括流产(OR=4.582,P<0.05)、转移(OR=4.695,P<0.05)和癌病史(OR=4.695,P<0.05)。结论妊娠滋养细胞疾病的误诊率高,其误诊与患者流产、疾病转移和癌病史等相关,应联合超声、血h CG和癌病史等多方面因素对妊娠滋养细胞疾病进行鉴别诊断。
Objective To investigate the misdiagnosis and reasons of gestational trophoblastic diseases and provide evidence for the differential diagnosis of gestational trophoblastic diseases. Methods Totally 86 patients with gestational trophoblastic disease admitted to our hospital from January 2006 to January 2014 were selected, of which 25 cases were misdiagnosed as other diseases. Statistics patients were misdiagnosed disease conditions and analysis of misdiagnosis of gestational trophoblastic disease causes. Results The overall misdiagnosis rate was 29.07%. The proportion of misdiagnosed as dysfunctional uterine bleeding was 6.98%. The proportion of patients misdiagnosed as endometrial dysplasia was 5.81%. The proportion of patients misdiagnosed as incomplete abortion was 5.81 %, Misdiagnosed as ectopic pregnancy was 4.65%, misdiagnosed as tuberculosis was 3.49%, misdiagnosed as osteosarcoma patients was 2.33%, the proportion of misdiagnosed diseases was significantly different (P <0.05). Univariate analysis showed that the causes of misdiagnosis of gestational trophoblastic diseases included age, miscarriage history, pregnancy history, metastasis and cancer history. Multivariate analysis showed that misdiagnosis of gestational trophoblastic diseases included miscarriage (OR = 4.582, P <0.05), metastasis (OR = 4.695, P <0.05) and cancer history (OR = 4.695, P <0.05). Conclusions The rate of misdiagnosis of gestational trophoblastic diseases is high. Misdiagnosis is associated with abortion, disease metastasis and cancer history. Combined diagnosis of gestational trophoblastic diseases should be made by the combination of ultrasound, blood hCG and cancer history.