Khaĭtov A
Vutr Boles. 1977;16(3):38-42.
The diagnosis of viral hepatitis was not confirmed in 2976 (22.79%) out of the admitted to the hospital patients for a period of 15 years. What impresses is the percentage growth for the last several years, reaching to 30. This, on one hand is associated with the greater exigence of HEI and with the strong fear of that disease as well as with the improved diagnostic possibilities of the infectious diseases wards on the other. In fact, almost all patients with icterus were admitted to infectious diseases wards, where the differential diagnosis of icterus was made. The first place among the false diagnoses is occupied by liver-bile diseases, progressing with icterus-50.81%, (cholelithiasis-29%, carcinoma-11%, cirrhosis, chronic hepatitis, steatosis, cholangiohepatitis, pancreatitis, etc-10.8%). Second, according to incidence, come the gastrointestinal diseases-13.51%, grippe and grippe-like diseases-13.44%, lung diseases-5.21%, blood-3.80%, heart-3.16%, toxic hepatitis 3.26%, etc. Thirty cases of infectious mononucleosis with icterus are reported as well as 17 patients with liver etzymopathies, syndrome of Dublin--Johnson--6 and Gilbert--Meulengracht syndrome--11. Viral hepatitis diagnosis is not always easy and in many cases it requires a complex of laboratory and other investigations and many years of experience. However, the false diagnosis could be reduced with more than a half with the careful consideration of the epidemic situation, anamnestic and clinical data.
在15年期间入院的患者中，2976例（22.79%）未确诊为病毒性肝炎。令人印象深刻的是过去几年的百分比增长，达到了30%。一方面，这与医院感染控制的更高要求、对该疾病的强烈恐惧以及传染病病房诊断可能性的提高有关。事实上，几乎所有黄疸患者都被收治到传染病病房，在那里进行黄疸的鉴别诊断。误诊中首位是肝胆疾病，伴有黄疸进展的占50.81%（胆结石占29%，癌症占11%，肝硬化、慢性肝炎、脂肪变性、胆管肝炎、胰腺炎等占10.8%）。其次，按发病率排序，是胃肠道疾病占13.51%，流感和类流感疾病占13.44%，肺部疾病占5.21%，血液疾病占3.80%，心脏疾病占3.16%，中毒性肝炎占3.26%等。还报告了30例伴有黄疸的传染性单核细胞增多症以及17例患有肝酶病的患者，其中杜宾 - 约翰逊综合征6例，吉尔伯特 - 默伦格拉赫特综合征11例。病毒性肝炎的诊断并不总是容易的，在许多情况下需要一系列实验室检查和其他检查以及多年的经验。然而，通过仔细考虑疫情、既往史和临床数据，误诊率可以降低一半以上。
