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題 名 | Delayed Diagnosis of Lung Cancer in Taichung Veterans General Hospital=臺中榮總肺癌病患之延遲診斷 |
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作 者 | 張開明; 徐武輝; 金湘玲; 江自得; | 書刊名 | 胸腔醫學 |
卷 期 | 13:1 1998.03[民87.03] |
頁 次 | 頁7-14 |
分類號 | 415.468 |
關鍵詞 | 延遲診斷; 肺癌; X光片; Delayed diagnosis; Lung cancer; Chest radiographs; |
語 文 | 英文(English) |
中文摘要 | 肺癌致死率目前位居世界諸癌症之首。在國人癌症大十死因中,肺癌始終盤據前 兩名。檢視過去療效不彰的原因,主要是病患在確定診斷時多非早期肺癌。而早期診斷,早 期治療,正是處理肺癌的最關鍵策略。從另觀點言之,癌症診斷的延誤已成為醫療糾紛之主 因,所導致的賠償金額亦十分驚人,更徨論醫事行為納入消保法的後果。故避免延誤診斷乃 臨床及放射線醫師之要務 為了解並檢討臺中榮總肺癌病患在診治期間被延誤診斷之情況,我們針對近三年內診斷為肺 癌之病人中,找尋被延誤診斷達四個月以上,分析其相關臨床資料,延誤之原因及X光片的 表現。最常見之延誤原因為未在X光片發現病灶,多數病灶位於上肺葉,多數病灶大小介於 1.0至1.9公分,而腺癌較扁平細胞癌有較長之延誤時間。我們提供以上結果,做為臨床或放 射線醫師之參考,期能使肺癌之延誤診斷降至最低。 |
英文摘要 | Delayed diagnosis of lung cancer may delay proper management of patients, which is the major cause of negligence litigation. From October 1992 to September 1995, in Taichung Veterans General Hospital, forty patients with lung cancer were found to have delayed diagnosis. The causes of delayed diagnosis included failure to detect the lesions on the chest radiographs (CXRs) (n=21), failure to recognize the lesions on the CXRs (n=4), inability to inform patients and clinicians (n=6), patients' factors (n=7) and technical factors (n=2). Most lestions were located in the periphery of the lung (n=31, 77.5%) and in the upper lobes (n=25), left upper lobe (n=16), right upper lobe (n=9). Patients with adenocarcinoma were delayed longer than those with squamous cell carcinoma. The sizes of most lesions were initially between 1.0 to 1.9 cm (53%) in diameter. Most of the lesions were masked by some thoracic structures, such as bones, vessels, heart, etc. All the lesions were potentially resectable when the initial positive CXRs were taken. Only eight patients received operations. Clinicians and radiologists should be alert in interpretaion of CXRs and try to detect the tumors as early as possible. |
本系統中英文摘要資訊取自各篇刊載內容。