论文部分内容阅读
目的：探讨两种胸痛诊断流程图诊断主动脉夹层的检出率异同并分析其原因。方法回顾性分析42例主动脉CTA证实为急性主动脉夹层的病例资料，分别用我国2014年胸痛临床评估与诊断流程图及2014年欧洲心脏病学会（European Society of Cardiology，ESC）急性胸痛诊断流程图进行诊断，评价其检出率。结果用我国胸痛流程图诊断的检出率为80.95%，用2014ESC急性胸痛诊断流程图诊断的检出率为88.10%，检出率差异无统计学意义（P>0.05）。结论两种胸痛诊断流程图对主动脉夹层均有较高的检出率，但均不能涵盖不典型主动脉夹层的诊断；在使用我国2014年胸痛诊断流程图进行ST段抬高型心肌梗死诊断时，需注意排除主动脉夹层的可能。“,”Objective To investigate the difference in detection rate of acute aortic dissection (AAD) with 2 kinds of chest pain flow chart. Methods 42 patients with ADD confirmed by computed tomography angiography and increased D-dimer underwent examination by the 2014 chest pain clinical assessment and diagnosis flow chart and European Society of Cardiology (ESC) acute chest pain diagnosis flow chart successively. The detection rates were compared. Results The detection rate of ADD by the 2014 chest pain clinical assessment and diagnosis flow chart was 80.95%, not significantly different from that by the ESC acute chest pain diagnosis flow chart (88.10%, P>0.05). Conclusion These 3 kinds of chest pain flow chart s help diagnose ADD, but have little value in detection of atypical ADD.