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首页医学资讯Blog优质医学医生们最常漏诊的疾病

医生们最常漏诊的疾病

这里是5种令人不安的医生们常常忽略的疾病。为什么会这样呢?又该怪谁呢?

 

     当我们去看医生时,我们都认为获得一个诊断和治疗方案是很简单的事。而且,我们想当然地以为诊断是正确的,诊断过程中没有遗漏任何东西。

 

      不幸的是,初级医疗的实际情况相差很大。美国医学期刊内科学杂志发表的一篇研究为了试着找到那些最常被漏诊的情况及其原因,回顾了190例诊断错误的医学记录。该文章描述的大部分诊断错误都有引起巨大危害和并发症的可能。事实上,约翰霍普金斯医院的研究人员估计每年在美国有一百多万人因医生的诊断错误而受伤。

 

     那么究竟要怪谁呢?人们很自然地会指向医生,指责他们的疏忽和无能。尽管医生们很容易成为问责目标,但实际情况明显要复杂的多,在医疗系统中,医生和患者在这个错误中都有责任。

 

      从医疗角度看,初级医疗医生通常要负责大型社区,因此他们被无数的预约所淹没且时间紧迫。 

 

      该文章显示大部分错误都与医患临床相遇的分解有关。意思就是这些错误是由于询问病史、体格检查、预定诊断性检查等过程中的数据收集与合成问题(比如认知错误)以及未能回顾既往档案而造成的。

 

      其他两个与档案相关的问题是显而易见的。首先,81.1%的个案在索引访问中没有记录在案的不同诊断,而索引访问是诊断推理过程中最基础的一步。其次,7.4%的案例中,医生们仅仅把之前的诊断过程复制粘贴到索引访问中;而这些案例中,三分之一以上的诊断错误是由复制粘贴错误引起的。

 

      数据收集和合成问题不仅仅是医生的责任。在很多个案中,是患者本身犯错。这发生在当回答一些敏感或尴尬问题时,患者会回避答案或伪装反应。患者并非刻意隐瞒信息,很多时候是因为患者没有意识到他们所隐瞒的信息与他们的病情有关。当临床画面缺乏重要信息时,诊断错误也就不足为奇了。  

 

      当然,有时候谁也没有错。约三分之一的患者表现出与正确诊断无关的症状,这些无关症状在初级诊疗的短暂时间内分散了医生的注意力。

 

请注意,以下是一些经常被忽略的情况:

  1. 肺炎
  2. 失代偿充血性心衰
  3. 急性肾衰
  4. 癌症(初期)
  5. 尿路感染或肾盂肾炎

 

      意识是避免错误诊断的最好方法之一。同其他任何领域一样,人为错误也存在于医学领域;因此获取第二意见对确认您是否健康真的很重要。如果您在看医生时或看医生后的任何一点上有疑问,请毫不犹豫地寻求第二意见或要求额外检查。

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