【Summary 】 the leukemia leak to diagnose, the reason of the misdiagnosis be mainly the following is 3, one is symptom and blood elephant of leukemia not typical model;It two, examination the personnel’s business level be not even, some people lack understanding of system to the advanced instrument function, didn’t do overall analysis to the excrescent result, the blindness sends out a report and result in each kind of leukemia leak to diagnose thus, misdiagnosis;It three, in the diagnosis process of leukemia, the clinical doctor’s technique level isn’t even to cause the misdiagnosis leak to diagnose.Aim at these three kinds of reason, should adopt resolute measure, attain to in time and accurately discover a leukemia, also provide some helps in the make a diagnosis and give treatment of leukemia the process for the person of same belief.
The leukemia is a kind of white cell malignant sharply increase rare disease.The outbreak rate of our country is higher, each 10 myriad peoples in have 2 leukemia sufferers with 4 ～s, and the leukemia outbreak rate have year by year increase of trend.On the other hand increment because of the healthy consciousness of people, hygiene knowledge exaltation, can make sick early diagnose to early cure.On the other hand modern disease diagnosis the means continuously develops, medical treatment examination the instrument be gradually advanced and make the disease is in the its Yin bud appearance namely is examine.But, under many circumstances cause the leukemia leak to diagnose because of various reason, the phenomenon of the misdiagnosis have occurrence.Many person of same beliefs once leaked to diagnose towards cause leukemia as well and the reason of the misdiagnosis once makes a summary report a way.The writer process is long-term clinical grope for, to leak of leukemia diagnose, misdiagnosis phenomenon, tally up a some experience to realize, hope to give person of same belief that more help is in the make a diagnosis and give treatment of leukemia the process.Leak to diagnose, the familiar reason of the misdiagnosis, mainly have a few aspects as follows.
The symptom of one leukemia not typical model, take some symptom as an outstanding performance, such as the part bleed, infection or ENS gradually but lack familiar chaperonage the sufferer’s blood elephant of the symptom leukemia not typical model, appeared in early days anemic, or white cell, blood plateletses all in normally the scope, the outside week blood didn’t appear immature cell.
2 examination personnel’s levels aren’t even, some people lack to understand completely to the advanced instrument function, did to analyze completely to the excrescent result, the blindness sends out a report and result in each kind of leukemia leak to diagnose thus, misdiagnosis
2.1 some medical examiners lack rightness not the impatient leukemia of the know of typical model leukemia rise disease nasty, the clinical performance is varied, often with hot, bleed, liver, Pi, lymphoid knot swollen big, bone joint pain is characteristics, separately sufferer with the kidney function crock up, gall bladder burning is outstanding performance.Parts of medical examiners because of lacking enough understanding to the leukemia clinical non- typical model symptom, the way of thinking is narrow, even if blood normal regulations report an abnormality, still with lend subjective judgment, don’t be Tu2 Pian4 Jing4 check, the blindness sends out a report list, with the result that the leukemia cell leaks check.For example one middle age male sufferer, swell to seek medical advice because of the right hip in May, 2006, check the hemoglobin 108 gs/L, the white cell is 7.1 ×s 109/L, the blood platelets is 109 ×s 109/L, lymphoid cell 0.24, neutral grain cell 0.74, list pit cell 0.01, love an acidity grain cell 0.04, love an alkaline grain cell 0.06.Because the sufferer only expresses a light degree anemic, do not make a mirror check classification, clinical diagnosis part infection, income surgery treatment.Usage antibiotics cure for a week, the right hip swells to ease, the right thigh swells obviously, the 10 d goes a blood normal regulations examination again behind, the white cell is 41.3 ×s 109/L, the hemoglobin 79 gs/L, the blood platelets is 27 ×s 109/L, lymphoid cell 0.02, list pit cell 0.08, love an acidity grain cell 0.01, love an alkaline grain cell 0.02, neutral grain cell 0.87, be not Tu2 Pian4 Jing4 check, past have no immature cell report, but clinical consideration for the blood disease, do marrow to wear to stab, diagnose to early take care of the young for the acute a grain of cell leukemia.The clinical examination personnel should acquaint with an impatient leukemia of various clinical performance characteristics, be hemoglobin, blood platelets decrease, the white cell surmounts a normal reference value, or keeps the blood specimen of square diagram abnormality all to check in response to Tu2 Pian4 Jing4 and keep each kind of leukemia cell from leak check.
2.2 personnel the margin of of the character and high technology currently, the part is clinical to examine a worker and analyzing an instrument to the importing blood of clinical usage can go deep into understanding and masterly control completely.The American BACKMAN.Coulter type lately ushered in such as my hospital full-automatic blood analysis the instrument can test to find out 22 parameters in the 1 min, can make a specimen meaning to report, that machine adopts the analysis principle of the electric resistance anti- of local and widespread usage, according to the blood cell after dissolving a blood a function is decided white cell cents a result by pit and the afterbirth quality grain structure size.Lymphoid cells include lymphoid cell, different type cell, original young cell, hair cell, strach cell;The list pit cells include the list pit cell, immature cell, love sour cell and love alkali cell;Grain cells include pole form cell and divide a leaf a grain cell and differ from the mirror check appearance credit.Because part examination the personnel lacks enough understanding to the instrument function and mistaken for instrument white cell cents result commutability mirror check classification, with the result that the leukemia cell leaks a check circumstance have occurrence.Like a 46 years old female sufferer, bleed to my hospital to seek medical advice because of the nose, gum, through 2 blood normal regulations check, the hemoglobin 110 gs/L, the blood platelets is 31 ×s 109/L, the white cell is 12 ×s 109/L, lymphoid cell 0.73, list pit cell is 0.12, neutral grain cell 0.12, love an acidity grain cell 0.02, love an alkaline grain cell 0.01, do not make an immature cell report.Doctor’s beginning diagnoses to deliver sex blood platelets decrease purple Dian at first and hospitalize treatment on the 7th day the marrow wear to stab the diagnosis as impatient and lymphoid cell a leukemia, the outside week cell with immature blood reaches to at this time 0.36.
2.3 whether the diagnosis had a high responsibility each kind of leukemia mainly according to the analysis of the laboratory blood and the marrow elephant, is get accurate result, request examining a personnel has to have a high responsibility, masterly control instrument function and operate regulations and check blood analytical result hour then can attain completely, elaboration, then can discover leukemia cell in time.Currently, because of being subjected to an examination the personnel draw up of restriction, the blood normal regulations of each big hospital examination workload more big, if the responsibility isn’t strong, is an only mechanical operation, or only satisfy in brief numerical analysis, then easiest cause a leukemia to leak to diagnose, misdiagnosis.
3 in the diagnosis process of leukemia, clinical doctor the technique level be not even and clinical impatient have fever and have already carried on sex up any sufferer anemic with(or) bleed tendency, the beard considers the possibility of impatient leukemia, according to the blood elephant and the marrow elephant usually not difficult make to visit patients at home to break, but still have parts of cases can because of following reason but misdiagnosis.
3.1 clinical thinking not overall impatient leukemias can involve in whole body several systems, leukemia cell can gradually many dirty machines, and propagate in the part, produce various special clinical performance.Have with the bone joint symptom, breathe in the sufferer, cardiovascular, nervous system performance the leader hair symptom, only basis these more obvious head hair symptom but neglect other symptoms to easily diagnose, easy misdiagnosis.Clinical doctor’s knowledge of have owes completely, don’t have enough understanding to this disease, attention part but neglect whole, in detail and systematically do not inquire the history of sufferer’s disease.The physical examination isn’t careful, if some sufferer’s check-ups have medium degree anemic looks, the breastbone presses a pain obviously, the sufferer, who have, is dizzy and tired, complexion pale, but the doctor valued, only with the history of disease and simple the body advertise for to recklessly make a paroxysm diagnosis and don’t have laboratory and apparatus check, or do of not enough accurate.There is once report way in domestic time of equally confirm of the leukemia be 6 weeks.The domestic once reported the misdiagnosis rate of a leukemia sufferer to reach to 41.16% as well, the most short 2 weeks, most grew for 9 months.
3.2 not fitting treatments cover up a condition press diagnose at first the symptom usually can get to temporarily alleviate after the treatment, but the condition still can continue to make progress, so in response to careful observation condition, analyze a check further, avoid delay more with long hours.Not enough hour of proof’s leading to early give may cover up symptom and interference laboratory to check by hormone treatment and influence diagnosis thus.Some grass-roots hospitals or condition are general of hospital when the disease confirmed, don’t blindness treatment, should after deluxe hospital confirm cure again.Have a report way 33% sufferers before confirm once because of use a radical plain treatment delay diagnosis, past to diagnosis indetermination, don’t abuse hormone.
3.3 didn’t carry on the marrow check end blood normal regulations to hint an abnormality in time, but can’t diagnose a leukemia, should make a marrow check in time.The data show that while confirming an impatient leukemia, the outside week blood has already had an excrescent change to have 90% and still have white about 10% suffererses cell a number normal, only performance hemoglobin and(or) blood platelets reduce.This sufferer needs more periodically with visit, many times, again and again check the end blood cell appearance, go a marrow check in time, can have another part check or marrow to live check when it’s necessary.Aim at to appear a leukemia misdiagnosis and leak the of same race circumstance for diagnose, need to actively adopt certain measure.The reason that, the leukemia appears a misdiagnosis and leaks to diagnose, in addition to some earlier period symptoms of leukemias not and obviously and outside mainly result in to°from the artificial factor.So, reduce misdiagnosis, leak to diagnose, will raise an examination the character of the personnel and clinical doctor.For examination worker, want to insist incumbency education first, raise a theories technique level.Along with science and technology of quick development, the forerunner’s whole bloodses automatically analyze an instrument electric resistance anti-, laser, radio frequency , calculator etc. technique consociation examination, comprehensive analysis blood cell, correspond to examination personnel’s character request to be more and more high also.A qualified examination personnel should have firm medical science foundation theories, examination technical ability with certain foreign language foundation.Examine the top of the personnel has to through training hard and cautiously read instrument usage manual before the Gang, understand its structure and control operation regulations and regulation.Secondly build up to recheck system.Currently, the blood of many categories analysis instrument to result abnormality of the circumstance can make a various marking, pass to recheck, can affirm a some and excrescent circumstance, discover that some qualities control aspect of shortage of place, thus and consumedly raise an examination report quality.The blood rechecks system and should include a following contents:Check on that day quality to control a data.The blood used at the our country bigger hospital analysis instrument’s have another have already established a data a processing function, we want to well make use of an advanced technique, whole blood the quality control thing and BULL to float to all be worth a method consociation usage, strictly to instrument measurese of various parameters carry on quality to control and make the monitor be placed in to circulate under the precise appearance at any time.To the adoption float three cell parameters of be worth the method analysis all, the any index sign 3 times outruns 3% in a row or 5 times is 3%s at 2% ～s in a row, can make instrument to lose control a processing.Want to actively check to seek reason at this time, quasi- instrument in the school, can to a large extent reduce the instrument”false masculine gender” to report to the police a circumstance;Check various results whether in the reference the scope.Have to be the check of Tu2 Pian4 Jing4 to confirm greatly part of excrescent markings that the instrument report for various blood specimen of excrescent or warnning marking data, and belong to for the excrescent marking what property make appropriate judgment.The writer suggest the applied blood analyzes an instrument of examination section, should blood Tu2 Pian4 dye mirror check row still in the blood normal regulations the work and avoid a clinical symptom not typical leukemia leak to diagnose, misdiagnosis.For the clinical doctor, carry on personnel’s education for all-round development, raise a personnel a theories technique level.The clinical doctor thoughts to up want to carry on a full value to the sufferer of similar leukemia, raise a vigilance, expand thinking, to sufferer’s condition carry on completely, thorough of analysis, not the important cause individual symptom and body advertise for very much resembling and other diseases but misdiagnosis.Understanding and vigilance of exaltation to this disease are the keys of detection and diagnosis.The leukemia’s clinical performance is each different, gradually extensive, but the majorities all start to have a disease dangerous, irregularly fear cold have fever, dizzy, tired, ear Ming, nose Nyu, gum bleed, the skin Yu order, the Yu spot, issue of blood order, blood in urine, black then, the skeleton press pain, have another a dirty machine damage etc., meet to have the above-mentioned expressional case, should thought of a leukemia, do relevant of laboratory check, such as the blood normal regulations, marrow wear to stab Tu2 Pian4 a check, live organization check and set to turn…etc..The clinical doctor should disregard to the undergraduate course professional disease, study related and professional knowledge more, study hard, frequently think and frequently consider, with decrease leukemia of misdiagnosis, leak to diagnose, exaltation earlier period diagnosis rate.In fine, only recognize a pure leukemia to leak to diagnose, the reason of the misdiagnosis, and adopt certain measure, then can as far as possible reduce a leak of leukemia to diagnose, misdiagnosis phenomenon, provide some helps in the make a diagnosis and give treatment of leukemia the process for the person of same belief
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