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醫生們最常忽略的疾病

來自: Medix團隊

這裡例舉了5種最常被醫生漏診的疾病。為什麼會這樣?要怪誰呢?

當我們去看醫生時,我們都認為獲得一個診斷和治療方案是很簡單的事。而且,我們想當然地以為診斷是正確的,診斷過程中沒有遺漏任何東西。

 

      不幸的是,初級醫療的實際情況相差很大。美國醫學期刊內科學雜誌發表的一篇研究為了試著找到那些最常被漏診的情況及其原因,回顧了190例診斷錯誤的醫學記錄。該文章描述的大部分診斷錯誤都有引起巨大危害和併發症的可能。事實上,約翰霍普金斯醫院的研究人員估計每年在美國有一百多萬人因醫生的診斷錯誤而受傷。

 

     那麼究竟要怪誰呢?人們很自然地會指向醫生,指責他們的疏忽和無能。儘管醫生們很容易成為問責目標,但實際情況明顯要複雜的多,在醫療系統中,醫生和患者在這個錯誤中都有責任。

 

      從醫療角度看,初級醫療醫生通常要負責大型社區,因此他們被無數的預約所淹沒且時間緊迫。

 

      該文章顯示大部分錯誤都與醫患臨床相遇的分解有關。意思就是這些錯誤是由於詢問病史、體格檢查、預定診斷性檢查等過程中的數據收集與合成問題(比如認知錯誤)以及未能回顧既往檔案而造成的。

 

      其他兩個與檔案相關的問題是顯而易見的。首先,81.1%的個案在索引訪問中沒有記錄在案的不同診斷,而索引訪問是診斷推理過程中最基礎的一步。其次,7.4%的案例中,醫生們僅僅把之前的診斷過程複製粘貼到索引訪問中;而這些案例中,三分之一以上的診斷錯誤是由複制粘貼錯誤引起的。

 

      數據收集和合成問題不僅僅是醫生的責任。在很多個案中,是患者本身犯錯。這發生在當回答一些敏感或尷尬問題時,患者會迴避答案或偽裝反應。患者並非刻意隱瞞信息,很多時候是因為患者沒有意識到他們所隱瞞的信息與他們的病情有關。當臨床畫面缺乏重要信息時,診斷錯誤也就不足為奇了。

 

      當然,有時候誰也沒有錯。約三分之一的患者表現出與正確診斷無關的症狀,這些無關症狀在初級診療的短暫時間內分散了醫生的注意力。

 

請注意,以下是一些經常被忽略的情況:

1. 肺炎

2. 失代償充血性心衰

3. 急性腎衰

4. 癌症(初期)

5. 尿路感染或腎盂腎炎

 

      意識是避免錯誤診斷的最好方法之一。同其他任何領域一樣,人為錯誤也存在於醫學領域;因此獲取第二意見對確認您是否健康真的很重要。如果您在看醫生時或看醫生後的任何一點上有疑問,請毫不猶豫地尋求第二意見或要求額外檢查。

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