电子结肠镜检查中误漏诊的相关因素分析

摘要

目的 分析电子结肠镜检查中误漏诊的相关因素及规律.方法 回顾性分析1998年1月～2007年12月本地区门诊和住院患者的电子结肠镜检查资料,获取误漏诊病例;检索中国知网1998～2007年国内文献报道的电子结肠镜检查误漏诊病例,并进行对比分析.结果 本地区行电子结肠镜检查9304例,其中401例误漏诊(4 3%);检索文献行电子结肠镜检查624例,其中26例误漏诊(4 2%).电子结肠镜误漏诊相关因素包括疾病类型及病变部位、检查环境因素(胃肠道准备欠佳、无辅助人员、医院级别低、设备配置差)和医生技术水平因素(包括从事电子结肠镜检查的时间、操作问题、活检情况)等.结论 电子结肠镜检查致误漏诊的相关因素复杂,提示临床可通过不同途径加以改进,以减少误漏诊.%Objective To analyze the frequency and risk factors of the misdiagnosis and missed diagnosis in the examination of electronic coionoscopy.Methods The electronic colonoscopy examination data of inpatients and outpatients from January 1998 to December 2007 in our district were selected and analyzed respectively, and the misdiagnosis and missed diagnosis cases were analyzed and compared with those reported by CNKI form 1998 to 2007.Results In our district, 9304 cases underwent the electronic colonoscopy, among whom, 401were misdiagnosed or missed misdiagnosed, with a rate of 4.3％; 624 cases who underwent electronic colonoscopy were searched from CNKI, among whom, 26 were misdiagnesed or missed misdiagnosed, and the msidiagnosed rate was 4.2％.The relevant factors included disease categories and region, environmental factors of endoscopy ( inadequate gastrointestinal tract preparation, no auxiliary personnel, lower hierarchy of the hospital, poor level of appliance) and professional level of doctors( experience of the physicians, problem of examination, pathological condition)etc.Conclusion The relevant factors of misdiagnosis and missed diagnosis in the examination of electronic colonoscopy may be complex, so doctors should take different measures to reduce misdiagnosis and missed diagnosis.