急性白血病在不同级别医院误诊的危险因素分析

摘要

Objective:To study the misdiagnosis risk of acute teukemia (AL) at different graded hospitals. Methods:The misdiagnosis rate and risk extent were analysed on 173 cases with retrospective study,χ2 and Ridit analysis were applied. Results:The misdiagnosis rate was 6.79% at hematolgy department of provincial hospital,and it varied between57.14% and 92.96% at the other different graded hospitals.The rankings of hospitals were related to misdiagnosis risk extent,and the misdiagnosis rate was high while the misdiagnosis risk exten was big in non-hematolgy department of provincial hospital.Conclusions:It was suggested that the training of general practitioner should be enhanced and the suitable AL diagnosis net-work established.It could reduce the misdiagnosis rate of AL in short time if we could lay stress on performing bone marrow smear check in time.%目的　探讨急性白血病(AL)在不同级别医院误诊的危险程度。　方法　采用回顾性调查方法，通过χ2检查和Ridit分析，研究了173例AL在不同级别医院的误诊率和误诊危险程度。　结果　省级医院血液专科AL首诊误诊率为7.69%，其他各级别医院误诊率为57.14%～92.96%。医院级别和误诊的危险程度相关，基层医院误诊率高，省级医院非血液专科误诊的危险程度高。　结论　加强全科医生的培养，在不同地区配置合理的AL诊断网络，同时特别重视骨髓穿刺检查，将有助于在短期内降低AL误诊率。