儿童卵黄囊瘤16例首诊误诊因素分析

目的 总结儿童卵黄囊瘤的临床特点,探究影响误诊的相关因素.方法 在2020年9月2日—12月2日以病友QQ群中45例儿童卵黄囊瘤为调查对象,设计调查问卷,收集临床资料,将患儿分为误诊组及未误诊组,分析误诊相关因素.结果 首诊误诊率35.56％,误诊组首发症状最多为排便困难,其中11例误诊为其他疾病(便秘3例,急性肾衰竭...

Analysis of Misdiagnosis Factors in 16 Children with Yolk Sac Tumor at First Visit

Objective To summarize clinical characteristics of paediatric yolk sac tumor and to explore the related factors affecting misdiagnosis.Methods A total of 45 children with yolk sac tumor in the QQ group from September 2,2020 to December 2,2020 were selected as the survey subjects.Questionnaires were designed,and clinical data was collected.The patients were divided into misdiagnosis group and non-misdiagnosis group,and related factors of misdiagnosis were analyzed.Results The misdiagnosed rate at first visit was 35.56%.Difficult defecation was the most common initial symptom in misdiagnosis group.Among them,11 patients were misdiagnosed as having other diseases(3 as having constipation,2 as having acute renal failure,2 as having teratoma,1 as having bound,1 as having inguinal hernia,1 as having hydronephrosis,1 as having alteration of intestinal flora),while 4 patients were thought to be normal,and 1 was recommended to be kept on observation.Among the 45 patients,16 patients(35.56%)were confirmed based on CT/MRI imaging examinations combined with increased AFP;15 patients(33.33%)were confirmed based on pathological examinations of surgical mass removal;11 patients(24.44%)were confirmed according to the puncture biopsy of masses,and 3 patients(6.67%)were confirmed according to the masses detected by color Doppler ultrasound combined with increased AFP.The misdiagnosis rate in non-provincial hospitals was higher than that in provincial hospitals,and the misdiagnosis rate of yolk sac tumor in the sacrococcygeal region was higher than that in non-sacrococcygeal region,and the differences were statistically significant(P<0.05).There were no significant differences in misdiagnosis rates among children with different genders,presence or absence of tumors and different clinical stages(P>0.05)Conclusion The misdiagnosis rate of yolk sac tumor in children is relatively high.The diagnosis ability and understanding of doctors in primary hospitals need to be enhanced,and local lumps and difficult defecation should be paid more attention in differential diagnosis for infants and young children.Imaging examinations and serum AFP detection are conductive to confirming the diagnosis early.