《中国康复理论与实践》

《中国康复理论与实践》 ›› 2004, Vol. 10 ›› Issue (05): 299-301.

• 临床研究 • 上一篇    下一篇

肌萎缩侧索硬化99例诊断过程分析

沈扬; 刘小旋; 周棉; 樊东升; 徐迎胜; 张华刚; 张俊; 康德   

  1. 北京大学第三医院神经内科 北京市 100083
  • 收稿日期:2004-02-12 出版日期:2004-05-25 发布日期:2004-05-25

Diagnostic process in 99 cases with amyotrophic lateral sclerosis

SHEN Yang, LIU Xiao-xuan,ZHOU Mian, et al   

  1. Department of Neurology, Peking University Third Hospital, Beijing 100083, China
  • Received:2004-02-12 Published:2004-05-25 Online:2004-05-25

PDF (PC)

被引次数

15

摘要： 目的探讨影响肌萎缩侧索硬化(ALS)诊断过程及误诊的主要相关因素,从而寻找可能的解决办法。方法回顾性分析1999—2003年我院收治的99例ALS患者,对其临床特点及诊断过程进行统计学分析。结果患者平均确诊时间为(13.1± 7.5)个月,肌电图检查的时间与确诊时间正相关。患者来我院之前的误诊率为58.6%,最常见的误诊疾病为颈椎病。40—59岁年龄段患者的误诊率要高于其他年龄段,以上肢和球部症状起病患者的误诊率低于以下肢症状起病患者。早期行颈椎MRI检查的患者误诊率偏高。结论导致ALS患者误诊的原因,主要是医生对此病认识不足、对影像和电生理检查结果的错误解释等。

关键词: 肌萎缩侧索硬化(ALS), 诊断, 误诊

Abstract: ObjectiveTo explore the factors that delayed the diagnostic process and resulted in misdiagnosis of amyotrophic lateral sclerosis (ALS),in order to look for solution. MethodsThe records of 99 cases with ALS from 1999 to 2003 in our hospital were reviewed retrospectively. Clinical characteristics and diagnostic process on the patients were statistically analyzed.ResultsThe time needed to confirm diagnosis was (13.1±7.5) months. There was a positive correlation between the time when EMG was performed and the time the diagnosis was made. 58.6% of patients were initially misdiagnosed in other hospitals. The most common misdiagnosis was cervical spondylosis. The misdiagnosis more likely occured in the patients of 40-59 years old. The misdiagnosis rate in the patients with initial lower extremities symptoms was higher than that with initial bulbar and upper extremities symptoms. The misdiagnosis more likely occured in patients with early cervical MRI.ConclusionThe major causes of misdiagnosis are unfamiliarity of the physician with the disease,misleading findings or misinterpretation of neuro-radiological or neuro-physiological findings.

Key words: amyotrophic lateral sclerosis, early diagnosis, misdiagnosis