988例有机磷农药中毒误诊分析
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- 英文论文题名：The misdiagnosis analysis for 988 cases of organophosphorus pesticide poisoning
- 论文作者：董建光 ; 邱泽武
- 年：2016
- 作者机构：解放军第307医院中毒救治科;
- 论文关键词：有机磷农药 ; 中毒 ; 误诊
- 英文论文关键词：Organophosphorus pesticide ; Poisoning ; Misdiagnose ; Database
- 会议召开时间：2016-06-17
- 会议录名称：2016中国中毒救治首都论坛——暨第八届全国中毒及危重症救治学术会议论文集
- 语种：中文
- 分类号：R595.4
- 学会代码：ZGDV
- 会议名称：2016中国中毒救治首都论坛——暨第八届全国中毒及危重症救治学术会议
- 会议地点：中国北京
- 主办单位：中国毒理学会中毒与救治专业委员会
- 学会名称：中国毒理学会
- 页数：3
- 文件大小：294k
- 原文格式：O
- 会议级别：全国
摘要
目的:探讨我国有机磷农药中毒误诊的情况和原因,提高对有机磷农药中毒的认识。方法:采用计算机检索2004-2013年发表在中文医学期刊并经遴选纳入误诊疾病数据库的有机磷中毒文献,进行误诊原因分析。结果:符合要求文献共125篇,对纳入文献研究分析显示,误诊病例988例,平均误诊率18.69%;误诊范围涉及62种疾病,其中误诊疾病居前3位的是急性胃肠炎、肺炎、食物中毒,占误诊疾病总数的57.36%。误诊原因有11种,医生问诊及体格检查不细致占92.06%、病人主述或代述病史不确切占55.56%,有机磷农药中毒相关知以缺乏占34.13%。988例误诊病例中,936例(94.74%)未因误诊误治造成不良后果:40例(4.05%)造成死亡;1例造成手术扩大化或不必要手术。结论:详细询问病史及体格检查,提高对有机磷农药中毒的认识及培养科学的诊断思维方法是减少有机磷农药中毒误诊的主要措施。
Objective:By analyzing the causes and the misdiagnosis of organophosphorus pesticide poisoning situation in our country,to improve the understanding of organophosphorus pesticide poisoning.Methods:According to the articles published in Chinese medical journals from 2004 to 2013 in the misdiagnosed diseases database about organophosphate poisoning literature by computer search,to analyze the misdiagnosis reasons.Results:Analysis on 125 articles shows that misdiagnosed case count for 988,with an average of misdiagnosis rate of 18.69%.The misdiagnosed cases cover 62 types diseases,and the top three are:acute gastroenteritis,pneumonia and food poisoning.accounting for 57.36%of the total number of misdiagnosed cases.Based on the 125 articles,the frequency and the constituent ratio of misdiagnois causes are determined,and the top are the doctor visits and careless physical examination.accounting for92.06%.Among 988 cases,there are936 cases with bad consequences because of misdiagnosis.accounting for 94.74%,and 40 cases with severe consequences,one patient resulting in surgical magnifying or unnecessary surgery.Conclusion:It implies that clinicians should deepen the understanding of organophosphorus pesticide poisoing.The possibility of organophosphorus pesticide poisoning should be considered when come across M or N symptoms that cannot be explained by merely one reason.To reduce the misdiagnosis ratio.medical history and physical examination should be seriously taken differential diagnosis should be intensified.
Objective:By analyzing the causes and the misdiagnosis of organophosphorus pesticide poisoning situation in our country,to improve the understanding of organophosphorus pesticide poisoning.Methods:According to the articles published in Chinese medical journals from 2004 to 2013 in the misdiagnosed diseases database about organophosphate poisoning literature by computer search,to analyze the misdiagnosis reasons.Results:Analysis on 125 articles shows that misdiagnosed case count for 988,with an average of misdiagnosis rate of 18.69%.The misdiagnosed cases cover 62 types diseases,and the top three are:acute gastroenteritis,pneumonia and food poisoning.accounting for 57.36%of the total number of misdiagnosed cases.Based on the 125 articles,the frequency and the constituent ratio of misdiagnois causes are determined,and the top are the doctor visits and careless physical examination.accounting for92.06%.Among 988 cases,there are936 cases with bad consequences because of misdiagnosis.accounting for 94.74%,and 40 cases with severe consequences,one patient resulting in surgical magnifying or unnecessary surgery.Conclusion:It implies that clinicians should deepen the understanding of organophosphorus pesticide poisoing.The possibility of organophosphorus pesticide poisoning should be considered when come across M or N symptoms that cannot be explained by merely one reason.To reduce the misdiagnosis ratio.medical history and physical examination should be seriously taken differential diagnosis should be intensified.
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