误诊为神经病变的八例糖尿病骨质疏松临床分析  

Clinical Analysis of 8 Cases of Diabetic Osteoporosis Misdiagnosed as Neuropathy

作　　者：谢红[1] 孙卫东[1] 胡楠[2] XIE Hong;SUN Wei-dong;HU Nan(Department of Geriatrics, the Fourth People's Hospital of Zigong, Zigong, Sichuan 643000, China;Department of General Surgery, the Fourth People's Hospital of Zigong, Zigong, Sichuan 643000, China)

机构地区：[1]自贡市第四人民医院老年病科,四川自贡643000 [2]自贡市第四人民医院普外科,四川自贡643000

出　　处：《临床误诊误治》2019年第3期9-12,共4页Clinical Misdiagnosis & Mistherapy

基　　金：四川省卫生厅科研基金资助项目(130142)

摘　　要：目的分析糖尿病骨质疏松误诊为神经病变的相关原因,以降低误诊率,提高临床诊治水平。方法回顾性分析2016年1月—2017年12月我院收治的误诊为神经病变的糖尿病骨质疏松8例的临床资料。结果本组误诊时间2～16个月,误诊为多发性周围神经炎3例,植物神经功能紊乱2例,左上肢尺神经痛、右上肢尺神经痛、右侧坐骨神经痛各1例,均予相应处理后未见好转。所有患者均进一步行血尿钙磷检查及骨密度检测,确诊为糖尿病骨质疏松,予以降糖、补钙、止痛等对症治疗后好转出院。结论糖尿病骨质疏松缺乏典型的临床症状,接诊医生应加强对糖尿病骨质疏松相关知识的了解,增强警惕性,以减少或避免误诊。ObjectiveTo analyze the causes of misdiagnosis of diabetic osteoporosis (DO) as neuropathy, in order to reduce the misdiagnosis rate and improve the level of clinical diagnosis and treatment. MethodsClinical data of 8 patients with DO misdiagnosed as neuropathy admitted to our hospital from January 2016 to December 2017 were retrospectively analyzed. ResultsIn this group, the duration of misdiagnosis was 2-16 months. Three patients were misdiagnosed as multiple peripheral neuritis, 2 as autonomic nerve dysfunction, 1 as ulnar nerve neuralgia in left upper extremity, 1 as ulnar nerve neuralgia in right upper extremity, and 1 as right sciatica. There was no improvement after the corresponding treatment. All the patients underwent further serum calcium and phosphorus test and bone mineral density test, therefore, DO was confirmed. After symptomatic treatment such as blood sugar control, calcium supplementation and pain relief, their conditions were improved and they were discharged from hospital. ConclusionDue to atypical clinical symptoms, the doctors should strengthen the understanding and vigilance of DO, so as to reduce or avoid misdiagnosis.

关 键 词：骨质疏松 糖尿病 误诊 糖尿病神经病变 

分 类 号：R681[医药卫生—骨科学]