摘要
目的探讨急性冠脉综合症(ACS)误诊的临床原因及预防措施。方法回顾性分析78例ACS患者的病历资料。结果78例入院时诊断为急性心力衰竭25例,低血容量性休克5例,消化性溃疡5例,肩周炎5例,急性胃肠炎4例,急性胆囊炎4例,急性胰腺炎4例,颈椎病4例,肋间神经痛3例,频发房性早博4例,频发室性早博3例,心源性猝死3例,牙髓炎2例。结论ACS临床表现具有复杂性,特殊人群不典型的临床表现较多,详细的病史采集、动态心电图和心肌损伤标志物监测是降低误诊率的关键。
Objective To discuss the misdiagnosis reasons for acute coronary syndrome, and measures to reduce the rate of misdiagnosis and improve the accuracy of diagnosis. Methods The medical records of 78 cases of acute coronary syndrome were analyzed retrospectively and the reasons for misdiagnosis were identified. Results There was a high rate of misdiagnosis about acute coronary syndrome, in which 25 cases were misdiagnoscd as acute heart failure on admission, 5 as hypovolemie shock, 5 as peptic ulcer, 5 as scapulohumeral periarthritis, 4 as acute gastroenteritis, 4 as acute cholecystitis, 4 as acute pancreatitis, 4 as cervical syndrome, 3 as intercostals neuralgia, 4 as frequent atrial premature beats, 3 as frequent ventricular premature beats, 3 as eardiogenic sudden death, and 2 as endodontitis. Diagnosis was delayed in some cases and the best time for treatment was missed. Conclusion The clinical manifestations of acute coronary syndrome are complex and in some cases, the clinical signs are untypical. Intimate medical history-taking, dynamic electrocardiogram, and myocardial damage marker detection are essential to reduce misdiagnosis rate.
出处
《实用医院临床杂志》
2008年第6期78-80,共3页
Practical Journal of Clinical Medicine
关键词
急性冠脉综合症
误诊原因
预防
Acute coronary syndrome
Misdiagnosis reason
Prevention
