儿童脊柱肿瘤就诊及诊断延误相关影响因素分析

Associated factors in delayed diagnosis of pediatric spinal tumors

中文关键词:  儿童  脊柱肿瘤  延误  诊断

英文关键词:Pediatric  Spinal tumors  Delay  Diagnosis

中文摘要:

  【摘要】 目的：探讨儿童脊柱肿瘤患者就诊、诊断延误情况的相关影响因素。方法：回顾性分析2007年1月~2017年1月就诊于我科的16岁以下脊柱肿瘤患者，收集其临床病例资料，记录患者性别、年龄、肿瘤侵袭性、病变节段、居住地、是否为独生子女、首次就诊医院的级别、是否受到错误诊断8个可能对就诊延误及诊断延误有影响的因素。采用单因素分析及多因素Logistic回归分析研究以上影响因素与就诊延误、诊断延误的关系。结果：共51例患儿纳入本研究，男28例，女23例，平均年龄9.5±4.1岁，就诊间期：1.3，（0~24）个月，就诊延误率为39.2%；诊断间期：1.0，（0~12）个月，诊断延误率为51.0%。单因素分析结果显示，发病年龄、病变部位和患儿居住地与延误就诊显著相关（P＜0.05），首诊医院级别、患儿居住地与延误诊断显著相关（P＜0.05）。多因素logistic回归结果显示，大龄患儿、病变位于腰骶椎为就诊延误的独立危险因素（P＜0.05），首诊医院级别为二级以下、患儿居于农村为诊断延误的独立危险因素（P＜0.05）。结论：大龄儿童、病变位于腰、骶椎患儿更易延误就诊；居住于农村、首诊为二级以下医院的患儿更易延误诊断。

英文摘要:

  【Abstract】 Objectives: To investigate the associated factors in delayed diagnosis of pediatric spinal tumors. Methods: Patients under 16 years old with spinal tumors were retrospectively investigated from January 2007 to January 2017. Age, gender, tumor characteristics, lesion segment, place of residence, only child or not, grade of first hospital visit, be wrongly diagnosed or not were collected according to clinical medical records. The correlation between patients and diagnosis delay and these factors were analyzed by single factor analysis and multiple-factor logistic regression. Results: 51 patients were retrospectively investigated. There were 28 males and 23 females. The mean age was 9.5±4.1 years. Patient lag time was 1.3, (0-24) months, diagnosis lag time was 1.0, (0-12) months. The rate of patient and diagnosis delay was 39.2% and 51.0% respectively. Age and lesion segments were found significant correlation with patient delay(P＜0.05). Grade of first hospital visit and place of residence were found significant correlation with diagnosis delay(P＜0.05). Multivariate analysis showed that older children and lesion in lumbar or sacral vertebra are independent risk factors for patient delay(P＜0.05), meanwhile, grade of hospital first visited is primary hospital or children lived in rural re independent risk factors for diagnosis delay(P＜0.05). Conclusions: Lesions in lumbar and sacral vertebra and older children easily lead to patient delay. When grade of first hospital visit is primary hospital or children lived in rural, diagnosis delay is more common.