论文部分内容阅读
目的：探讨非ST抬高急性冠脉综合征(ACS)患者的急诊分层诊断的可行性，提高急诊医师对非ST抬高ACS的诊断水平。方法前瞻观察性研究，胸痛及胸痛等同症状急诊就诊的患者。急诊医师通过临床分层诊断将患者分为ACS组和非ACS组，随访确诊的结果或30 d后的临床转归情况。所有数据经SPSS17.0统计软件进行统计学处理。结果入选200例，有效188例，其中ACS组106例，确诊ACS94例，非ACS组82例，随访30天，确诊ACS2例，无死亡病例。急诊分层诊断流程及标准对非ST抬高ACS诊断的敏感性为97.9%，特异性为87.0%。结论急诊医生经过培训，通过对非ST抬高ACS患者的分层诊断，可初步实现非SF抬高ACS的早期诊断及规范化治疗，改善患者预后，降低漏诊率，避免过度医疗。“,”Objective To explore the feasibility of hierarchical diagnosis on non-ST-elevation acute coronary syndrome (NSTEACS) and improve accuracy of the diagnosis in practice in emergency room (ER). Methods In such a prospective and observational research, the patients with chest pain or equivalent syndrome are divided into acute coronary syndrome (ACS) group and non-ACS group, and their respective diagnosis result and the 30-day’s follow-up were analyzed with SPSS17.0 software. Results In a total of 188 participated patients, the two groups were identified as ACS group of 106 of which 94 of them were identified as ACS, and non-ACS group of 82 of which 2 were found as ACS in the 30-day’s follow-up. No death case was found. As a result, hierarchical diagnosis carries out a 97.7% accuracy with a differentiate rate of 87.0%. Conclusion Hierarchical diagnosis is considered being effective in diagnosing accuracy and standardizing and providing the proper treatment to those who suffered from NSTE-ACS in emergency room.