【摘要】 目的:探讨鼻咽癌的误诊原因及对策。方法:对416例初治的鼻咽癌患者的临床资料进行回顾性分析。结果:总误诊率42%,前3位的误诊疾病分别为中耳炎、鼻(窦)炎和颈部淋巴结炎。中位延误诊断时间为3(0～60)个月,其中患者原因及医源性原因各占一半。首发症状、初诊医院等级及科室是影响医源性诊断延迟的重要因素。结论:鼻咽癌较高的初诊误诊率与非鼻咽相关症状、初诊为乡镇医院及非耳鼻喉科就诊相关。普及鼻咽癌知识、加强医生继续教育及采取适当的奖罚机制可能有助于降低鼻咽癌的误诊率。更多还原

【Abstract】 Objective:This work aims to explore the cause and countermeasures of misdiagnosis of nasopharyngeal carcinoma(NPC). Methods:The naive NPC patients diagnosed in Zhejiang Cancer Hospital in 2011(from January 1 st to December 31 st) were enrolled in this study.The patients’ medical records were retrospectively reviewed and analyzed.Results:Up to 416 cases were involved in the study. The misdiagnosis rate was 42%.The medial delay time in diagnosis was three months(range:0 - 60),in which patient-related factors equally contributed to the iatrogenic factors for the diagnosis delay.Initial symptoms,the levels of the hospitals,and related divisions for preliminary diagnosis were important factors that influenced misdiagnosis.Conclusions:NPC patients suffer from high misdiagnosis rate,which is related to non-specific symptoms of the nasopharynx,low-level hospitals in small towns,and visiting wrong divisions that are usually not special departments of otorhinolaryngology.Improving people’s awareness of NPC,intensifying continuous medical education of doctors,and establishing a reward and punishment system may reduce misdiagnosis of the cancer.更多还原