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目的探讨多联指标分析法对急诊急性主动脉夹层识别和诊断价值。方法回顾性分析32例急性主动脉夹层患者的多项临床资料,分析多联指标分析法诊断急性主动脉夹层的可靠性。结果符合指标1(胸痛、腹痛和背痛,伴坐卧不安躁动感)的患者有28例,符合指标2(休克样表现)为26例,符合指标3(双侧血压差)为21例,符合指标4(神经体征)为8例,符合指标5(D-二聚体升高)为29例,符合指标6(胸片纵隔增宽)为18例。32例患者多指标分析得分与确诊例数中3分的患者占最大比例,4分其次。得分为3分患者中,指标1+指标2+指标5的组合确诊率最高,指标1+指标3+指标5次之。结论运用多联指标分析法能对急诊急性主动脉夹层进行快速高效的诊断,可靠性高,为对后续诊治和降低医疗风险有重要意义,对一线医师尤其是基层医师具有极高的临床意义。
Objective To explore the value of multi-index analysis in the identification and diagnosis of acute aortic dissection. Methods The clinical data of 32 patients with acute aortic dissection were retrospectively analyzed. The reliability of the diagnosis of acute aortic dissection was analyzed by using multiple index analysis. Results In line with the index 1 (chest pain, abdominal pain and back pain, with restless restlessness dynamic) in patients with 28 cases, in line with the index 2 (shock-like performance) was 26 cases, in line with the index 3 (bilateral blood pressure difference) In line with the index 4 (neurological signs) in 8 cases, in line with the index 5 (D-dimer increased) was 29 cases, in line with the index 6 (chest X-ray widened) was 18 cases. 32 patients with multiple-indicator analysis of the score and the number of patients diagnosed 3 points accounted for the largest proportion of 4 points followed. The score of 3 points in patients, the indicator 1 + index 2 + 5 combination of the highest rate of diagnosis, index 1 + index 3 + 5 times. Conclusions Multi-index analysis can be used to diagnose emergency acute aortic dissection quickly and efficiently with high reliability, which is of great significance for follow-up diagnosis and treatment and reduction of medical risks. It is of great clinical significance for first-line physicians, especially primary physicians.