误诊文献数据库2004—2013年单病种误诊文献研究:眼内异物  

Diagnostic Data Analysis for Single Disease from Diagnostic Diseases Databases(2004—2013):Intraocular Foreign Body

作　　者：刘洁[1] 刘迎庆[2] 

机构地区：[1]解放军白求恩国际和平医院信息科,石家庄050082 [2]解放军白求恩国际和平医院眼科,石家庄050082

出　　处：《临床误诊误治》2016年第8期36-40,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨眼内异物的临床特征、误诊原因及其防范措施。方法对误诊文献数据库收录的2004—2013年国内发表的眼内异物误诊文献61篇进行分析。结果共纳入眼内异物误诊文献61篇389例,其中提供误诊率的文献2篇55例,误诊13例,误诊率23.64%;没有提供误诊率的文献59篇误诊376例。文献来源于三级医院居多(39篇,63.9%),二级医院次之(20篇,32.79%)。本组延误诊断时间最短12 h,最长26年;误诊疾病达36种,居前5位的误诊疾病误诊例次从多到少依次是角膜炎、葡萄膜炎、结膜炎、眶蜂窝织炎及白内障,占误诊疾病的73.28%,个别患者曾误诊为2种以上疾病;7例造成严重不良后果。结论问诊及体格检查不细致及经验不足、缺乏对该病认识是导致眼内异物误诊的主要原因。提高对眼内异物复杂性的认识,详细询问外伤史及仔细查体,及时行相关医技检查是减少或避免眼内异物误诊的关键。Objective To investigate clinical feature and misdiagnosis causes of intraocular foreign body so as to provide preventive and treatment measures. Methods Clinical data of 61 papers about intraocular foreign body,which were searched from diagnostic diseases＇ databases from 2004 to 2013,was retrospectively analyzed. Results The total misdiagnosis number was 61 papers（ 389 cases）,13 cases were included in 55 cases（ 2 papers） with misdiagnosis rate paper,and the misdiagnosis rate was 23. 64%; 376 cases were included in papers without misdiagnosis rate. Papers were mainly from Three A hospitals（ 39 papers,63. 9%）,and followed by Two A hospitals（ 20 papers,32. 79%）. The shortest delayed time of misdiagnosis for intraocular foreign body was 12 h,while the longest time was 26 years. Misdiagnosed diseases involved 36 kinds of diseases,and the top five diseases were as follows; keratitis,uveitis,conjunctivitis,orbital cellulitis and cataract,accounted for 73. 28% of misdiagnosed diseases,and some patients were misdiagnosed with two or more diseases. 7 patients suffered from serious outcomes. Conclusion The main misdiagnosis causes of interrogation and physical examination are careless inquisition and physical examination,and lack of experience and understanding of intraocular foreign body. Clinicians should enhance understanding of the complexity of intraocular foreign body,ask for a detailed history of trauma and perform a thorough physical examination in order to prevent misdiagnosis.

关 键 词：眼异物 误诊 角膜炎 葡萄膜炎 

分 类 号：R779.14[医药卫生—眼科]