摘要
目的对强直性脊柱炎延误诊断情况及原因进行分析.方法选取我院2013 年1 月-2015 年12 月门诊及住院的168 例强直性脊柱炎患者进行研究,对患者延误诊断情况从性别、年龄、发病症状、家族史、诊断方法、误诊科室及辅助检查等方面进行分析,对延误诊治的原因进行总结.结果 168 例患者中,145 例存在误诊情况,误诊率86.31%,且所有误诊患者均未采用骶髂关节X 线检查.首诊误诊延误时间方面,非风湿免疫科延误诊断时间为(68.72±34.17)个月,风湿免疫科延误诊断时间为(29.31±16.42)个月,与非风湿免疫科延误诊断时间相比,风湿免疫科延误诊断时间较短,差异有统计学意义(t =8.792,P < 0.05);与行骶髂关节CT 检查的患者相比,行骶髂关节X 线平片检查延误诊断时间为(49.34±19.18)个月,CT 检查延误诊断时间为(38.42±17.59)个月,骶髂关节CT 检查延误诊断时间较短,差异有统计学意义(t =5.336,P < 0.05).结论强直性脊柱炎延误诊断与非风湿免疫科医师不熟悉非强直性脊柱炎疾病相关,对强直性脊柱炎早期诊断中,X 线及CT 诊断均存在不足,临床中建议应用MRI 诊断.
Objective To analyze the diagnosis and causes of ankylosing spondylitis. Methods A total of 168 patients with ankylosing spondylitis were enrolled in our hospital from January 2013 to December 2015. The diagnosis was delayed in terms of gender, age, symptoms, family history, diagnosis, misdiagnosis and analyze the auxiliary examination and other aspects to summarize the reasons for delaying diagnosis and treatment. Results Of the 168 patients, 145 cases of misdiagnosis before hospitalization, The rate of misdiagnosis was 86.31%, and all patients with misdiagnosis did not use ankle X-ray. In the first diagnosis misdiagnosis delay time, the non-rheumatic immunology department delayed diagnosis time was (68.72±34.17) months, and the rheumatology immunology department delayed diagnosis time was (29.31±16.42) months. Compared with the non-rheumatic immunology department delay diagnosis time, rheumatology and immunology department Delayed diagnosis time was significantly shorter, the difference was statistically significant (t =8.792, P < 0.05);compared with patients undergoing ankle joint CT examination, the diagnosis time of X-ray plain film examination was (49.34±19.18) months, CT diagnosis delay diagnosis time was (38.42±17.59) months, and the diagnosis time of ankle joint CT examination was significantly shorter, the difference was statistically significant (t =5.336, P < 0.05). Conclusion The diagnosis of ankylosing spondylitis is related to non-rheumatic immunologists who are not familiar with non-ankylosing spondylitis. In the early diagnosis of ankylosing spondylitis, X-ray and CT diagnosis are insufficient. MRI diagnosis is recommended in clinical practice.
作者
高小娟
陈仁利
汤一榕
陈琦
GAO Xiaojuan;CHEN Renli;TANG Yirong;CHEN Qi(Department ofRheumatology, Ningde Hospital, Affiliated Hospital of Fujian MedicalUniversity, Ningde Fujian 352000, China)
出处
《中国卫生标准管理》
2019年第12期56-59,共4页
China Health Standard Management
基金
福建省宁德市指导性科技计划项目(20130195)
关键词
强直性脊柱炎
骶髂关节
X
线检查
CT
检查
延误诊断
原因
ankylosing spondylitis
ankle joint
X-ray examination
CT examination
delay diagnosis
reason
