青年结直肠癌15例误诊误治临床分析  

Clinical Analysis of Misdiagnosis and Mistreatment of 15 Youths with Colorectal Cancer

作　　者：孔宪诚[1] 沙粒[1] 阎良[1] 黄建平[1] 

机构地区：[1]上海中医药大学附属曙光医院普通外科,上海200021

出　　处：《临床误诊误治》2017年第6期23-25,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨青年结直肠癌的临床特点,分析误诊原因,提高诊治水平。方法回顾性分析我院2013年5月—2016年5月收治的15例曾误诊为其他疾病的青年结直肠癌的临床资料。结果本组误诊率为14.71%(15/102),平均误诊时间为(4.52±0.84)d。误诊为肠胃炎3例,肠梗阻、结肠炎、直肠息肉各2例,痔疮、细菌性痢疾、胃肠炎伴胆囊结石、急性胰腺炎、肛周脓肿及缺铁性贫血各1例。经乙状结肠镜、活组织病理检查、肛门指检等检查明确诊断,其中直肠癌8例,乙状结肠癌3例,盲肠癌、升结肠癌各2例。8例予择期手术等治疗后病情好转出院;6例予保守治疗,其中3例死亡;1例拒绝治疗要求出院。所有患者均行13年随访,其中1例死亡,3例复发,余均预后良好。结论临床应警惕青年结直肠癌发病可能,详细了解病史,完善相关检查,争取减少或避免误诊误治。Objective To investigate clinical features of youths with colorectal cancer so as to analyze misdiagnosis causes to improve treatment. Methods Clinical data of 15 misdiagnosed patients with colorectal cancer admitted during May 2013 and May 2016 was retrospectively analyzed. Results The misdiagnosis rate was 14.71% （1/102） , and average misdi- agnosed time was （4.52 ± 0.84） d. Among the 15 patients, there were 3 patients misdiagnosed as having gastroenteritis, 2 as having intestinal obstruction, 2 as having colitis, 2 as having rectal polyps, 1 as having hemorrhoids, 1 as having bacillary dysentery, 1 as having gastroenteritis associated by cholecystolithiasis, 1 as having acute panereatitis, 1 as having perianal ab- scess and 1 as having iron deficiency anemia. All patients were confirmed the diagnosis by sigmoid endoscopy, biopsy and anal examinations, and there were 8 patients with rectal cancer, 3 patients with sigmoid cancer, 2 patients with cecal cancer and 2 patients with ascending colon cancer. Elective surgery was performed for 8 patients, and the patients were discharged after conditions had improved; 6 patients received conservative treatment, of which 3 patients died; 1 patient refused treatment and discharged. All patients were followed up for 1-3 years, 1 patient died; 3 patients had recurrence; other patients had good prognosis. Conclusion Clinicians should pay attention to youths with colorectal cancer, and understand the history, related examinations, diagnosis and treatment should be done in great detail so as to avoid misdiagnosis and mistreatment.

关 键 词：结直肠肿瘤 青年人 误诊 胃肠炎 肠梗阻 结肠炎 

分 类 号：R735.34[医药卫生—肿瘤]