鼻咽部恶性肿瘤误诊误治48例临床分析  

Clinical Analysis about Misdiagnosis of 48 cases with Nasopharyngeal Malignant tumors

作　　者：崔志春[1] 成雷[1] 孙凤新[1] 韩旭[1] 刘勇[1] 

机构地区：[1]首都医科大学大兴医院耳鼻咽喉科,北京大兴102600

出　　处：《中国中西医结合耳鼻咽喉科杂志》2012年第4期290-292,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨鼻咽部恶性肿瘤误诊误治原因及提高早期诊断率的方法。方法对62例鼻咽部恶性肿瘤患者的临床资料进行回顾性分析,首次就诊取鼻咽部病理后确诊者14例(22.6%),因各种原因延误诊断治疗者48例(77.4%),其中鼻咽癌40例,鼻咽恶性淋巴瘤8例。我们采用调查问卷方式,对误诊科室,误诊疾病及误诊原因进行归纳总结。结果患者曾分别就诊于外科、耳鼻喉科、眼科以及神经内科等,被误诊的疾病包括颈部肿瘤、颈部淋巴结炎、颅内肿瘤、腺样体肥大、鼻咽炎、中耳炎、三又神经痛以及斜视等。误诊原因主要在于临床各科医生对鼻咽部恶性肿瘤症状的多样性及并发症认识不足,患者自身原因延误检查也是误诊的主要因素。结论临床各科医生应提高对鼻咽部恶性肿瘤临床症状及并发症的认识,加强科室间的协作,对可疑患者应详细询问病史,及早检查鼻咽部做活检甚至多次活检,可减少误诊的发生,提高早期诊断率。Objective investigate the cause of misdiagnosis of nasopharyngeal malignant tumors so as to improve the early diagnosis. Retrospective analysis about 62 cases with nasopharyngeal malignant tumors was conducted, 14 cases （22.6%） of which were correctly diagnosed by biopsy during their first visit. 48 cases （77.4%） with delayed diagnosis were recognized including 40 cases of nasopharynx cancer, and 8 cases of nasopharynx malignant lymphoma. A questionnaire was performed about the departemnt, misdiagnosed diseases and the reasons. Results： The Patients usual}y visited the department of surgery, otorhinolaryngology, ophthalmology, department of neurology, and so on. Misdiagnosed diseases included tumor colli, cervical lymphadenitis, intracranial neoplasm, adenoid hypertrophy, rhinopharyngitis, otitis media, trigeminal neuralgia, strabismus, etc. The main reasons could be attributed to a lack of knowledge on the various symptoms of nasopharyngeal malignant tumors and its complications for doctors. A delayed visit by patients themselves would also result in a misdiagnosis. Conclusion Careful inquires for suspicious patients, timely and even repeated biopsy, could be helpful for an early and correct diagnosis.

关 键 词：鼻咽癌 鼻咽部恶性肿瘤 误诊 

分 类 号：R739.63[医药卫生—肿瘤]