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急性心肌梗塞(AMI)如漏诊常导致严重后果。本文探讨AMI在急诊室漏诊患者的临床特征、病程及未能被收入院治疗的原因。自1984年1月至10月在本研究各有关医院急诊室就诊的3077例胸痛患者中,1794例收入住院,其中459例证实有AMI;1223例未能收入住院,其中18例为AMI。因此,在AMI患者中,96％收入住院,4％返回家,漏诊者占全组病例的0.6％。此外,还有17例AMI漏诊患者被检出。此35例未被收入住院治疗的原因可归于:Ⅰ,急诊室医师未能辨认出心电图中急性心肌缺血或将AMI的表现认为是陈旧的;Ⅱ,虽能识别为静息心绞痛或缺血性心电图表现却认为是陈旧的而允许病人出院;Ⅲ,其他原因。
Acute myocardial infarction (AMI) if missed, often leads to serious consequences. This article explores the clinical features of AMI patients missed in the emergency room, the course of the disease and can not be admitted to hospital treatment reasons. Of the 3077 patients with chest pain who visited the emergency departments of the relevant hospitals in this study from January to October 1984, 1794 were hospitalized, of whom 459 were confirmed with AMI, 1223 were hospitalized without income, and 18 were AMI. Therefore, among AMI patients, 96% were hospitalized and 4% returned home, accounting for 0.6% of all cases. In addition, 17 patients with missed AMI were detected. The reasons for these 35 cases of unadjusted hospitalization can be attributed to: i. The emergency room physician failed to identify the acute myocardial ischemia on the ECG or the appearance of AMI as obsolete; ii. Although identified as resting angina or ischemia Sexual ECG performance is considered outdated and allows patients to be discharged; Ⅲ, other reasons.