摘要
了解临床内科疑难病例诊断困难的原因。通过逐一阅读2001年~2014年《中华医学杂志》刊登的疑难病例评析文章,分别统计内科疑难病例相关文章发表的年代、科室（包括多学科联合）、病种。2001年~2014年《中华医学杂志》共发表259例疑难病例,各年代分布差异不大,发表疑难病例最多的前5位分别为风湿免疫科、呼吸科、血液科、内分泌科和神经内科。病例中涉及多学科（≥2）的共39篇,涉及多学科的病例中以风湿免疫科最多（共20篇）,涉及病种中前5位分别是淋巴瘤、系统性红斑狼疮、抗中性粒细胞胞浆抗体（ANCA）相关性小血管炎、结核病、肺动脉栓塞。259例疑难病例中属于罕见病仅占55%,余为常见病。为进一步提高疑难病的诊断水平,一方面要注意学习少（罕）见病,另一方面要提高临床思维水准,注意常见病的诊断思维,尤其注意多学科联合诊断,避免分科过细带来的局限性。
Understand the cause of the delaydiagnosis in difficut and complicated cases in internal medicine.We readed one by one the paper about difficult and complicated cases published in Chinese Medical Journal from 2001 to 2014and respectively statistic the year of article published,department,of kind of illness as well as cause of delaydiagnosis.Totall259 papers about difficult and complicated cases were pulished in Chinese Medical Journal during the period 2001~2014.The first five figure of the department correlated with published papers were in proper order the rheumatology,pulmonolgy,blood,endocrine and neurology.There were total 39 papers involved different department,among them the rheumatology is first in number（total 20papers）.The first five figure of illness correlated with respectively was malignant,lymphoma,systemic lapu erythematosus,ANCA relatede vasulitis,tuberculosis and pulmonary arterious embolism.Among 259 cases,about 55% belonged to seldom disease.Inorder to improve the level of diagnosis in difficut and complicated cases,it shoud to study seldem or rare seen cases of illness in one side,and in another side increase clinical thinking level and diagnosis level of the commen illness,especially to pay attention to combined diagnosis by differet department inorder to refrain from the limitation bringed by class fication to elaborate division.
作者
李喜忠
何权瀛
LI Xi- zhong HE Quan-ying(Lulong Country People＇s Hospital, Qinhuangdao 066499, Chin)
出处
《医学与哲学（B）》
2016年第12期53-55,87,共4页
Medicine & Philosophy(B)
关键词
诊断
疑难病例
罕见病
delay diagnosis
difficut and complicated cases
rare diseases
作者简介
李喜忠（1982-），男，主治医师，研究方向：呼吸与危重症。通讯作者：何权瀛（1944-），男，教授，主任医师，博士生导师，研究方向：睡眠呼吸障碍，支气管哮喘，慢性阻塞性肺疾病，医学人文。E-mail：hxk313@126．com
