腰椎间盘突出症合并腰部肿瘤漏诊原因及对策

目的 分析腰椎间盘同症合并腰部肿瘤漏诊的原因，提出诊断时应采取的措施。方法 回顾性分析了２１３９例腰椎间盘突出症患的临床资料，合并腰部肿瘤１１例，漏诊７例，从中找出漏诊的原因并进行分析。结果 ７例患均以腰椎间盘突出症为诊断收住院治疗，合并椎体转移瘤４例，合并硬膜内，硬膜外神经鞘瘤各１例，合并硬膜内囊性畸胎瘤１例，经ＣＴ强化，ＭＲＩ检查并结合临床化验确诊。结论：腰椎间盘突出症合并中肿瘤少见，常易漏诊，仔细询问病史，详细查体和必要的临床化验可减少漏诊，ＭＲＩ对腰部肿瘤的早期诊断有决定性意义。

Causes and Countermeasures of Evaded Diagnosis of Lumbar Tumors Combined with Lumbar Disc Herniation

Objective In order to analyze the causes of the evaded diagnosis of lumbar tumors combined with lumbar disc herniation and to put forward the countermeasures to avoid the evaded diagnosis.Methods The data of 2139 patients who had had lumbar disc herniation and had been in hospital were analyzed retrospectively.11 patients among them were combined with lumbar tumor and 7 patients evaded the diagnosis of tumor.The causes of the evaded diagnosis were found and the countermeasures to avoid the evaded diagnosis were put forward.Results The seven patients were all hospitalized with the diagnosis of lumbar disc herniation and four of them were combined with lumbar metastasis,three of them were combined with lumbar interdural and extradural schwannoma and lumbar interdural cystic teratoma respectively.The tumors were diagnosed by CT or MRI finally.Conclusions It is not common to be met in clinic that the lumbar disc herniation combined with lumbar tumor,however this is the common cause which caused the evaded diagnosis.The early diagnosis of lumbar tumors can be confirmed by the examination of MRI.