胆囊结石患者超声诊断结果漏诊及误诊分析  

Analysis of Misdiagnosis of Patients with Gallbladder Stone by Ultrasonography

作　　者：蒋龚彦[1] 朱建平[1] 林聪平 吴仲秋[1] 王露[1] 

机构地区：[1]南京军区福州总医院,福建福州350025

出　　处：《现代生物医学进展》2014年第36期7105-7107,7143,共4页Progress in Modern Biomedicine

基　　金：福建省科技厅重点项目(2014Y0035);国家自然科学基金项目(81070241)

摘　　要：目的:探讨我院胆囊结石患者超声诊断漏诊、误诊的超声诊断结果,并分析出现漏诊、误诊的原因。方法:选取我院肝胆外科经彩色多普勒超声诊断确诊并实施手术治疗的胆囊结石患者260例,结合临床资料分析患者彩色多普勒超声图的特点,并在术后一周进行随访,对彩色多普勒超声诊断的漏诊率及误诊率并分析原因。结果:1、胆囊结石分型:典型胆囊结石167例(64.3%)、充满型胆囊结石50例(19.2%)、多发性胆囊结石28例(10.8%)、泥沙样胆囊结石10例(3.8%),另外5例患者属非胆囊结石(1.9%);2、彩色多普勒超声确诊的260例胆囊结石患者经手术病理证实其中255例为胆囊结石,5例为非胆囊结石(2例为误诊,3例为漏诊),超声诊断的准确率98.1%。误诊、漏诊的发生与病灶部位、患者肥胖程度、仪器操作及医师经验等因素有关。结论:虽然彩色多普勒超声对胆囊结石的诊断率较高,但仍需完善,以减少或避免临床误诊和漏诊的发生。Objective： To explore the reasons of misdiagnosis of gallbladder stone disease for 260 patients by ultrasonic diagnosis.Methods： 260 patients with gallbladder stone disease who were diagnosed by color doppler ultrasound in our hospital were selected to be the objects. Then the missed diagnosis and misdiagnosis rates of color doppler ultrasound images were compared and analyzed. Results：1. A gallstone type： typical gallstone 167 cases（64.3%）, 50 cases of gallstones full type（19.2%）, multiple gallbladder stones in 28 cases（10.8%）, 10 cases of gallbladder stones sediment samples（ 3.8%） the other five cases were non- gallstone patients（1.9%）; 2. Color Doppler ultrasound confirmed 260 cases of gallbladder stone disease in which patients with pathologically confirmed 255 cases of gallbladder stone disease, five cases of non gallbladder stone disease（2 cases of misdiagnosis, three cases of misdiagnosis）, the accuracy of ultrasound diagnosis of 98.1 %. Ultrasound misdiagnosis occurred with patients the lesion site, the degree of obesity, instrument operation, physician experience and other factors. Conclusion： Although the high rate of color Doppler ultrasound diagnosis of gallbladder stone disease, but still improved to reduce or avoid the occurrence of clinical misdiagnosis and missed diagnosis.

关 键 词：胆囊石 彩色多普勒超声 误诊 漏诊 

分 类 号：R657.4[医药卫生—外科学]