早期误诊为肝性脑病患者的临床分析21例  

Clinical analysis of 21 cases with early misdiagnosis as hepatic encephalopathy

作　　者：隆莉[1] 张继万[1] 

机构地区：[1]武警四川总队医院感染科,四川省乐山市614000

出　　处：《世界华人消化杂志》2008年第19期2181-2183,共3页World Chinese Journal of Digestology

摘　　要：目的:研究早期误诊为肝性脑病的原因,提高对肝性脑病的认识.方法:采用回顾性调查方法,分析21例误诊为肝性脑病患者的早期误诊原因及临床特点.结果:确诊为低钠性脑病、酒精戒断综合征、慢性酒精中毒Wernicke脑病、低血糖昏迷、脑出血和尿毒症酸中毒,误诊原因:临床诊断思维狭隘,先入为主;对病情缺乏全面分析;问诊不仔细,查体不全面;对肝性脑病诊断及鉴别诊断不熟悉.结论:临床医师对肝病患者出现神经精神症状,应全面询问病史及仔细查体,及早进行相关的实验室检查,从诊断思维入手进行病因分析,避免误诊.AIM： To investigate underlying causes for early misdiagnosis as hepatic encephalopathy and thereby to gain a better understanding of hepatic encephalopathy. METHODS： Twenty-one cases misdiagnosed as hepatic encephalopathy were retrospectively analyzed, including their possible causes and clinical features. RESULTS： Final diagnosis included hyponatraemia encephalopathy, alcohol withdrawal syndrome, chronic alcoholism Wernicke enceph- alopathy, hypoglycemic coma, cerebral hemorrhage and uremia acidosis. The underlying causes for misdiagnosis may be： narrow clinical diagnosis thinking; lack of complete understanding of pathogenic condition; undetailed inquiry and check-up and failure to master differential diagnosis of hepatic encephalopathy. CONCLUSION： When patients with liver diseas-es present with mental disorders, detailed and complete inquiry and check-up are required, and relevant laboratory tests and causal analysis from perspective of diagnostic thinking should be done to avoid a misdiagnosis.

关 键 词：肝性脑病 早期诊断 误诊 

分 类 号：R447[医药卫生—诊断学]