论文部分内容阅读
目的:通过总结以特殊部位疼痛为首发症状的急性心肌梗塞病人的临床特点,分析首诊误诊原因,提出解决对策,以期减少基层首诊医生对此类病人的误诊率,提高病人预后。方法:对我院2007年1月至2011年1月接诊的45例以特殊部位疼痛为首发症状的急性心梗患者资料从年龄、性别、既往史、并存病进行回顾性分析。结果本组占同期收治的急性心梗病例总数的35.2%,首诊误诊28例,误诊率为62.2%。转送上级医院按急性心梗治疗后病情稳定25例,死亡3例。结论:对老年女性患者,或伴有糖尿病、高血压及有心衰病史的患者,初诊表现为不典型部位疼痛的病情,应想到急性心梗的可能;低年资医生应加深对心梗特殊部位疼痛机制的理解、病例资料总结和文献学习,以期尽早明确诊断,提高病人预后。
OBJECTIVE: To summarize the clinical features of patients with acute myocardial infarction, whose first symptom is the pain of special part, to analyze the causes of first diagnosis and misdiagnosis, and to put forward countermeasures to reduce the misdiagnosis rate of such patients and improve their prognosis. Methods: A retrospective analysis was conducted on 45 patients with acute myocardial infarction (MI) whose pain was the first symptom of special parts from January 2007 to January 2011 in our hospital from age, sex, past history and comorbidity. Results This group accounted for 35.2% of the total number of acute myocardial infarction cases treated in the same period, 28 cases were misdiagnosed as first diagnosis and 62.2% were misdiagnosed. Transferred to the higher level hospital after treatment of acute myocardial infarction in stable condition in 25 cases, 3 patients died. Conclusions: The diagnosis of atypical pain in the elderly female patients or patients with diabetes mellitus, high blood pressure and history of heart failure should be considered. The possibility of acute myocardial infarction should be considered. Part of the understanding of the mechanism of pain, case data summary and literature learning, in order to confirm the diagnosis as soon as possible to improve the prognosis of patients.