摘要
目的探讨减少急性致死性胸痛患者误诊率，缩短确诊时间的诊断方法和流程，从而使该类患者得到快速、有效的救治。方法回顾性分析2010—10～2011—03（对照组）及2011—10—2012—03（研究组）两个时间段内以胸闷、胸痛为主诉急诊就诊的患者。对照组以急诊护士站常规分诊，从急诊门诊或抢救室开始就诊，根据首诊医师个人判断决定下一步治疗措施；研究组统一于抢救室就诊并按照急性胸痛筛查流程图要求进行诊治。统计分析两组致死性胸痛患者的误诊率、就诊至确诊所需时间及医疗费用。结果致死性胸痛误诊率、救治至确定诊断时间及平均医疗费用，两组间比较差异有统计学意义（P〈0．05）。结论急性胸痛为主诉的患者，在急诊抢救室按照急性胸痛筛查流程救治可以明显减少致死性胸痛误诊率，缩短就诊至确诊时间，对患者得到及时、有效地救治起到积极的作用。
Objective To explore the diagnostic procedure of acute fatal chest pain in emergency department （ED） in order to decrease the misdiagnosis rate and shorten the definite time to diagnosis. The ultimate aim is to rescue the patients timely and effectively. Methods Three hundreds and two patients [ （56.9 ~ 11.8） years, 72% men] complained with acute chest pain and chest distress presenting to our ED were recruited. They were divided into two groups according to visiting time （Group I ： from October 2010 to March 2011, Group I1 ： from October 2011 to March 2012）. The misdiagnosis rate, definite time for diagnosis and medical expense were analyzed. Patients of Group I were diagnosed by initial doctors who made their diagnosis according to personal experience in outpatient service or rescue room in ED. While patients of Group II were all admitted to rescue room and were diagnosed and rescued according to the acute chest pain screening flow - process diagram. Differences inter - group was compared. Results There were statistical differences in misdiagnosis rate of fatal chest pain, the definite time to diagnosis between two groups（P 〈0.05）. and the mean cost for treatment. Conclusion Treating emergency patients with acute chest pain according to the acute chest pain screening flow - process diagram in rescue room will decrease misdiagnosis apparently, and it can also shorten the definite time to correct diagnosis. It has remarkable positive role in rescuing patients with acute chest pain timely and effectively.
出处
《中国急救医学》
CAS
CSCD
北大核心
2014年第5期423-425,共3页
Chinese Journal of Critical Care Medicine
关键词
致死性胸痛
急诊
急性胸痛筛查流程
误诊率
确诊时间
Fatal chest pain
Emergency
diagram
Misdiagnosis rate
Acute chest pain screening flow -process Definite diagnosis time
