反应性组织细胞增多症误诊分析及伦理反思  

Analysis and Ethical Thought of Misdiagnosis of Reactive Histiocytosis

作　　者：于晓原[1] 周冬枝[2] 权正良[1] 

机构地区：[1]西安交通大学医院,陕西西安710061 [2]西安交通大学第一医院,陕西西安710061

出　　处：《中国医学伦理学》2006年第4期90-90,109,共2页Chinese Medical Ethics

摘　　要：目的:分析反应性组织细胞增多症(Reactive H istiocytosis,RH)的误诊原因,以提高临床诊断的准确率。方法:9例RHR症状体征、血象、骨髓象,发病原因等临床资料,对误诊率及误诊原因进行分析。结果:误诊率高达66%,误诊为恶性组织细胞增多症(MalignantH istiocytosisMH)者占56%。误诊原因原发病症状不典型;临床医师对巨幼红细胞性贫血引起的RH病因认识不足;仅重视骨髓组织细胞百分比而忽视细胞形态学改变。结论:RH病因中血液亦可引起,RH组织细胞百分比可高于20%,医务工作者应加强医德审慎。Target： To improve the veracity of clinical diagnosis by means of analyzing the reasons for misdiagnosis of reactive histiocytosis. Method： Analyze the misdiagnosis rate and reasons according to the clinical data about symptoms, signs, blood profile、marrow profile and causes etc from 9cases of reactive histiocytosis. Results： The rate of misdiagnosis is as high as 66%, 56% of the patients are misdiagnosed as malignant histiocytosis. The reasons for the misdiagnosis are as following： ① The primary symptom is not typical enough; ② The clinicians have an insufficient knowledge about the re - active histiocytosis resulted from megalocytic anemia. ③ The clincians only paid attention to the percentage of the marrow histiocyte, but ignored the morphological changes of the cells. Conclusion： Blood diseases can also result in reactive histiocytosis, sometimes the percentage can be higher than 20%.

关 键 词：反应性组织细胞增多症 恶性组织细胞增多症 误诊 伦理分析 

分 类 号：R-052[医药卫生]