120例肺癌骨转移早期诊断分析并文献复习

目的:对肺癌患者骨转移早期症状及诊断情况进行分析,以提高肺癌患者骨转移的早期确诊率。方法:收集2002至2005年我院120例伴有骨转移相关症状的肺癌患者临床资料,分析骨转移早期症状和临床诊断情况。结果:肺癌患者易发生骨转移,骨转移部位主要有肋骨(51.7%)、胸椎(37.5%)、腰骶椎(32.5%)、骨盆(27.5%)等,早期主要症状表现为相应部位的疼痛、麻木、肌肉酸胀、骨关节功能障碍以及贫血临床上常误诊为腰椎间盘突出、椎体骨质增生、骨髓炎、骨折、风湿病、肩周炎、坐骨神经痛、颈椎病或肋骨炎等。结论:肺癌患者易发生骨转移,转移部位最常见的是肋骨、胸椎、腰骶椎和骨盆,骨转移早期症状常无特异性,容易误诊,腰椎转移误诊率最高,临床医师对肺癌骨转移应予以足够的重视,以减少误诊,提高确诊率,并制定准确的治疗方案,改善患者生存质量和临床治疗效果。

The analysis of early Symptoms and diagnssis of bone metastases in 120 patients with lung Cancer

Objective:To analyze the early symptoms and diagnosis of bone metastases in patients with lung cancer.Methods:From 2002 to 2005,120 cases with bone metastases were analysed.Results:The bone metastases was frequent in patients with lung cancer.The main metastasis sites were as follows:ribs(51.7%),thoracic vertebrae(37.5%),lumbar vertebrae(32.5%),pelvis(27.5%).The early symptoms of bone metastases were painness,numbness,anemia and dysfunction of bone or joint and they were mostly misdiagnosed as lumbar disc herniation,Hyperosteogeny,osteomyelitis,fracture,rheumatism,periarthritis of shoulder and so on.Conclusion:Bone metastasis in patients with lung cancer is an often event.The common metastatic sites were ribs,thoracic vertebrae,lumbar vertebrae and pelvis.The misdiagnosis rate is high due to the lack of specific characteristics at early stage of bone metastases.The clinical physician should pay more attention to the occurrence of bone metastases on patients with lung cancer.