55例骨髓增生异常综合征-难治性贫血误诊、漏诊原因  

Reasons of misdiagnosis and misdiagnosis of 55 patients with myelodysplastic syndromes-refractory anemia

作　　者：姜鹏 张福海 林旺 刘海明 JIANG Peng;ZHANG Fuhai;LIN Wang;LIU Haiming(Department of Laboratory Medicine,Pinggu Hospital,Beijing Friendship Hospital,Beijing 101200,China;Department of Hematology,Pinggu Hospital,Beijing Friendship Hospital,Beijing 101200,China)

机构地区：[1]北京友谊医院平谷医院检验科,北京101200 [2]北京友谊医院平谷医院血液科,北京101200

出　　处：《临床与病理杂志》2019年第2期287-293,共7页Journal of Clinical and Pathological Research

摘　　要：目的:分析骨髓增生异常综合征-难治性贫血(myelodysplastic syndromes-refractory anemia,MDSR A)误诊、漏诊原因,并探究降低误诊、漏诊率的有效方法。方法:统计中国知网(CNKI)中有关MDS-R A误诊、漏诊方面的文献,并统计出误诊、漏诊的高发病种及原因;通过取材、阅片及临床提供患者信息进行统计学分析,分析北京友谊医院平谷医院2006—2016年误诊、漏诊的55例MDS-RA患者高发病种及原因。最后将北京友谊医院平谷医院检验科骨髓室与文献的数据进行比较分析。结果:北京友谊医院平谷医院骨髓室误诊、漏诊的几种情况和文献基本一致,略有差别。从一般临床症状和基础检查方面看,这几种高发疾病与MDS-RA确实存在容易混淆的地方;但从细胞形态学角度存在显著差异,MDS-RA有较特异性的病态造血。结论:加强临床医生与检验技术人员的沟通、联合多种检测方法筛查是有效降低误诊、漏诊的重要预防措施。Objective:To analyze the cause of misdiagnosis and missed diagnosis of 55 cases with myelodysplastic syndromes-refractory anemia(MDS-RA)in the bone marrow chamber,and to find effective means to reduce the misdiagnosis rate.Methods:The literature on MDS-RA misdiagnosis and misdiagnosis in CNKI was counted,and the high incidence and causes of false/missed diagnosis were also calculated.After that,the patient information was analyzed by means of materials,tablets and clinical data,and analyzed the incidence and causes of the misdiagnosis and misdiagnosis of 55 MDS-RA patients in Pinggu Hospital of Beijing Friendship Hospital from 2006 to 2016.Finally,the data of this room and literature were analyzed.Results:The cases of misdiagnosis and misdiagnosis in the bone marrow chamber were basically consistent with the literature.From general clinical symptoms and basic examination,there were some areas where there was indeed confusion between these highonset diseases and the MDS-RA;however,there were significant differences in morphology of cells,and MDSRA had more specific pathological hematopoiesis.Conclusion:Strengthen communication between clinicians and laboratory workers and combined with multiple detection methods for screening are important preventive measures to effectively reduce misdiagnosis and missed diagnosis.

关 键 词：骨髓增生异常综合征-难治性贫血 误诊 漏诊 病态造血 预防措施 

分 类 号：R551.3[医药卫生—血液循环系统疾病]