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目的:研究床旁超声心动图在急性高危胸痛鉴别诊断和中西医结合治疗中的应用。方法:对2015年1月—2016年1月以急性高危胸痛收入我院急诊胸痛中心的156例患者行床旁超声心动图检查,并对结果进行整理、分析、归纳及总结。结果:床旁超声心动图协助临床确诊心肌梗死136例,其中70例经冠状动脉造影证实。床旁超声协助诊断气胸3例,床旁超声诊断肺动脉栓塞4例,后经生化检查及肺动脉血管造影证实,协助诊断主动脉夹层2例,经主动脉三维CT重建及动脉造影证实;另有11例,经床旁超声检查未见明显异常改变,后经详细检查,其中3例为颈椎病,2例为带状疱疹,2例急性胸膜炎,1例为急性心包炎,另2例胸痛自然缓解后出院,对于急性胸痛的治疗采取中西医结合治疗的方式。结论:床旁超声心动图在急性高危胸痛的鉴别诊断中至关重要,能够及时迅速的提供鉴别诊断信息,从而及时指导急性高危胸痛的诊断和中西医结合治疗。
Objective: To study the application of bedside echocardiography in the differential diagnosis of acute high-risk chest pain and the combination of traditional Chinese and Western medicine. Methods: From January 2015 to January 2016, bedside echocardiography was performed on 156 patients with acute high risk chest pain who were admitted to our hospital for acute chest pain. The results were summarized, analyzed, summarized and summarized. Results: Bedside echocardiography assisted in the clinical diagnosis of myocardial infarction in 136 cases, of which 70 cases confirmed by coronary angiography. Bedside ultrasound assisted diagnosis of pneumothorax in 3 cases, bedside ultrasound diagnosis of pulmonary embolism in 4 cases, after biochemical examination and confirmed by pulmonary angiography to assist in the diagnosis of aortic dissection in 2 cases, confirmed by aortic three-dimensional CT reconstruction and arteriography confirmed; another 11 For example, there was no significant abnormal change after bedside ultrasound examination. After detailed examination, 3 cases were cervical spondylosis, 2 cases were herpes zoster, 2 cases were acute pleuritis, 1 case was acute pericarditis and the other 2 cases were chest pain natural relief After discharge, for the treatment of acute chest pain to take Integrative Medicine approach. Conclusion: Bedside echocardiography is very important in the differential diagnosis of acute high-risk chest pain. It can provide differential diagnostic information timely and promptly to guide the diagnosis of acute high-risk chest pain and the combination of traditional Chinese and Western medicine.