中国大陆地区克罗恩病临床误诊的汇总分析

目的:了解我国大陆地区克罗恩病(Crohn’s disease,CD)的临床特征,尤其是病变部位及其累及情况,以及临床诊断上的误诊情况,为临床医生快速准确地诊断提供重要线索．方法:对我国近50 a来报道的CD文献资料通过计算机CBM与文献追溯检索,对符合文献入选标准的63篇文献有关误诊情况的数据进行摘录、登记、统计分析．结果:计入统计的CD患者共有1644例,误诊为肠梗阻与套叠为19．33％、肠道肿瘤为19．89％、腹部肿块为10．00％、回盲部占位为13．95％、肠结核为14．47％、溃疡性结肠炎为12．25％、慢性肠炎为33．85％、阑尾病变为17．54％．结论:CD的临床表现缺乏特异性,病变侵犯胃肠道任意部位,且常常侵犯多个部位,给临床诊断带来困难,极易导致误诊．

A combined analysis of clinical misdiagnosis for Crohns' disease in Chinese, mainland

AIM: To investigate the clinical features of Crohn's disease in China, especially the status, the locations of lesions and its misdiagnosis in clinics. METHODS: The literatures published in the recent 50 years (1950-1959) about CD were colleted from the Chinese database of Biology and Medicine (CBM, 1979-01/2003-12) by computer and tracing back year by year. All the data about the locations of lesions and misdiagnoses, as well as other demography features were recorded, pooled and statistically analyzed. RESULTS: There were 1644 cases of CD patients, of which 19.33% were misdiagnosed as intestinal obstruction and looping, 19.89% as intestinal tumors, 10.00% as abdominal mass, 13.95% as ileocecal space-occupying lesions, 14.47% as intestinal tuberculosis, 12.25% as ul-cerative colitis, 33.85% as chronic enteritis, and 17.54% as appendiceal diseases. CONCLUSION: CD has no specificity on clinical features, can affect any segment (often many segments) of the gastrointestinal tract from the mouth to anus, and induce the diver- sified clinical manifestations and high misdiagnosis.