89例血吸虫病误诊误治分析

目的分析血吸虫病误诊误治的原因及损害,探讨解决血吸虫病误诊误治的对策。方法收集1989年～2004年的血吸虫病住院病例资料,对其中院外误诊的病例进行全面详细的分析。结果261例血吸虫病患者中误诊89例,误诊率34.10%。89例入院前曾被误诊为脑肿瘤3例,肝炎2例,胆囊炎1例,肾炎2例,败血症2例,伤寒6例,肠炎4例,结肠炎2例,血液病2例,支气管肺炎3例,肺炎1例,支气管炎2例,感冒14例,扁桃体炎1例,尿路感染1例,疟疾1例,诊断不明并用抗生素治疗48例;被误诊2种疾病以上的4例。本组误诊误治的89例均发生在综合性医院,其中市级以上医院占87.64%。结论综合性医院的医生对血吸虫病缺乏认识是误诊误治的根本原因。误诊误治不仅给病人带来不必要的身心痛苦和经济损失,还导致了抗生素的滥用。加强疫区和非疫区城乡各级综合性医院医务人员的血吸虫病知识培训,提高医务人员对该病的诊断和鉴别诊断的能力,以减少误诊误治。

Analysis of misdiagnosis and mistreatment in 89 cases of schistosomiasis

Objective To analyse the cause and harmfulness of misdiagnosis and mistreatment in schistosomiasis and to explore the solutions . Methods The clinical data of 261 cases of schistosomiasis from 1989 to 2004 were collected and 89 cases with misdiagnoses were analyzed in detail. Results 89 (34.10%) out of 261 pantionts with schistosomiasis had been misdiagnosed, 3 cases as cerebral tumor, 2 hepatitis, 1 cholecystitis, 2 nephritis, 2 sepsis, 6 typhoid, 4 enteritis, 2 colitis, 2 hematopathy, 3 bronchopneumonia, 1 pneumonia, 1 bronchitis, 14 common cold, 1 tonsillitis, 1 urinary tract infection, 1 malaria, 48 cases obscure diagnosis and mistreatment. All misdiagnosed cases occurred in general hospitals, of misdiagnosed cases 87.64% were in municipal hospitals. Conclusion The main cause of misdiagnosis in schstomiasis is that the doctors if lacking of knowledge about the disease . The misdiagnosis not only bring a lot of suffering and economic loss to the patients but also abuse of antibiotics. Medical workers of the general hospital in urban and rural areas in epidemic areas and non-endemic areas of schistosomiasis must be strengthened to train for improving the ability of diagnosis and differentially diagnosis of schistosomiasis.