本文選題：竇血栓形成　切入點(diǎn)：顱內(nèi)　出處：《臨床誤診誤治》2016年04期

【摘要】：顱內(nèi)靜脈竇血栓形成(cerebral venous sinus thrombosis,CVST)臨床表現(xiàn)各異,體征不典型且多變,隨著診斷技術(shù)及臨床重視程度的提高,本病檢出率逐漸升高,但誤診率仍較高。2004—2013年發(fā)表在中文醫(yī)學(xué)期刊并經(jīng)遴選納入誤診疾病數(shù)據(jù)庫(kù)的CVST文獻(xiàn)共95篇,累計(jì)誤診病例674例,涉及誤診率文獻(xiàn)29篇654例,誤診例數(shù)284例,誤診率43.43%。誤診范圍涉及53種疾病,其中前4位誤診疾病是腦梗死、蛛網(wǎng)膜下腔出血、中樞神經(jīng)系統(tǒng)感染、病毒性腦炎。主要誤診原因?yàn)榻?jīng)驗(yàn)不足而缺乏對(duì)該病的認(rèn)識(shí)、缺乏特異性癥狀體征和未選擇特異性檢查項(xiàng)目。共438例誤診病例描述了誤診與疾病轉(zhuǎn)歸的關(guān)聯(lián),其中382例(87.21%)未因誤診誤治造成不良后果。提示臨床醫(yī)師應(yīng)提高對(duì)CVST的認(rèn)識(shí),對(duì)頭痛、嘔吐、顱內(nèi)壓升高、視力喪失者應(yīng)考慮本病可能,及時(shí)行頭顱磁共振血管成像和數(shù)字減影血管造影檢查并仔細(xì)鑒別診斷,以減少誤診的發(fā)生。
[Abstract]:The clinical manifestations of cerebral venous sinus thromboembolism (CVST) are different, the signs are atypical and changeable. With the improvement of diagnostic technique and clinical importance, the detection rate of CVSTs increases gradually.However, the misdiagnosis rate was still high. 95 CVST papers published in Chinese medical journals from 2004 to 2013 were selected and included in the misdiagnosis database. The total misdiagnosis rate was 674, the misdiagnosis rate was 29 articles, the misdiagnosis rate was 284 cases, and the misdiagnosis rate was 43.43%.The misdiagnosis scope involved 53 diseases, among which the first 4 misdiagnosed diseases were cerebral infarction, subarachnoid hemorrhage, central nervous system infection and viral encephalitis.The main causes of misdiagnosis were inexperience and lack of understanding of the disease, lack of specific symptoms and signs and lack of selection of specific examination items.A total of 438 misdiagnosed cases described the relationship between misdiagnosis and the outcome of the disease, among which 382 cases (87.21) did not have adverse consequences due to misdiagnosis and mistreatment.It is suggested that the clinicians should improve their understanding of CVST, and should consider the possibility of this disease in patients with headache, vomiting, elevated intracranial pressure and visual loss, and make a prompt examination of head magnetic resonance angiography and digital subtraction angiography, and make careful differential diagnosis.In order to reduce the incidence of misdiagnosis.
【作者單位】： 沈陽(yáng)軍區(qū)總醫(yī)院神經(jīng)內(nèi)科;
【基金】：遼寧省科技攻關(guān)計(jì)劃(2013225089;2014225008)
【分類號(hào)】：R743.33

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