鼻咽癌324例延误诊断原因分析

目的：探讨鼻咽癌延误诊断的原因。从而提高鼻咽癌患者的早期诊断率,改善治疗效果。方法：回顾性分析324例在我科接诊前因各种因素而延误诊断的鼻咽癌患者首发症状、首诊误诊科室、误诊疾病。结果：本组病例首发症状分别为颈部包块138例（42.5%）、鼻部症状148例（45.6%）、耳部症状66例（20.3%）、头痛46例（14.2%）、其他17例（5.2%）,有两种首发症状的病例为91例。首诊误诊的疾病有颈部淋巴结炎、慢性鼻-鼻窦炎、鼻出血、分泌性中耳炎、脑动脉硬化等27种疾病。涉及普外科、耳鼻咽喉科、神经内科、骨科、呼吸内科、口腔科、烧伤科、眼科、中医科等9个科室。结论：加强鼻咽癌知识普及,完善继续医学教育及住院医师培训,积极寻找鼻咽癌的早期诊断方法能减少鼻咽癌的延误诊断。

Analysis of Delayed Diagnosis in 324 Cases of Nasopharyngeal Carcinoma

Objective：Through discussing the causes of delayed diagnosis of Nasopharyngeal Carcinoma,this paper intends to improve the accuracy of early diagnosis and thus enhance the effect of treatment.Methods：Review and analyze the 324 cases of delayed diagnosis of Nasopharyngeal Carcinoma before we treated those new patients.Results：This series of symptoms includes 138 cases of cervical lymphade nopathy（42.5%）、148 cases of nasal part（45.6%）、66 cases of aural region（20.3%）、46 cases of headache（14.2%）、and 17 other cases（5.2%）.Besides,there are 91 casesof double symptoms.The 27 diseases that have been misdiagnosed includes cervix adenolymphitis、chronic rhinosinusitis、paranasal sinusitis、nasal hemorrhage、secretory otitis media、cerebral arteriosclerosis.The 9 related departments are general surgery、ENT departement、neurological Medical Department、department of orthopaedics、respiration Medical Department、department of stomatology、department of traumatology、department of ophthalmology、department of traditional chinese medicine.Conclusion：Promote the education on Nasopharyngeal Carcinoma;improve the doctors＇ further education and resident physician training;seek the ways of early diagnosis of Nasopharyngeal Carcinoma so as to largely reduce the cases of delayed diagnosis.