急诊超声心动图在高危胸痛病因鉴别诊断中的价值

The Value of Emegency Echocardiography in Differential Diagnosis of High-risk Chest Pain

目的:探讨急诊超声心动图(UCG)在高危胸痛病因鉴别诊断中的临床应用价值。方法:对2008-01-2010-01以急性高危胸痛收入心脏重症监护病房(CCU)的422例患者,行急诊UCG检查,并对结果进行分析、总结。结果:急诊UCG检出明确节段性室壁收缩运动障碍并协助临床确诊心肌梗死408例,其中108例经血管造影证实。急诊UCG纠正或修正初始诊断14例,其中主动脉夹层4例,经CT动脉造影证实;肺动脉栓塞8例,后经生化检查及CT动脉造影证实;另有2例胸痛患者,UCG未见明显异常改变,1例证实为胆囊炎合并结石急性发作,另1例胸痛自然缓解后出院。结论:急诊UCG在急性胸痛的病因诊断及鉴别诊断中起到了至关重要的作用,可作为首选的筛查手段。

Objective：To explore the clinical value of emergency echocardiography in the differential diagnosis of acute chest pain.Method：To analyze and summarize the emegency echocardiography date of 422 cases with acute chest pain in cardiac care unit（CCU） from January 2008 to January 2010.Result：Regional wall motion abnormality（RWMA） were detected by emergency echocardiography,and to assist the clinical diagnosis of myocardial infarction in 408 cases,of which 108 cases were confirmed by coronary angiography.Emergency echocardiography to correct or amend the initial diagnosis of 14 cases： of which 4 cases of aortic dissection,confirmed by CT angiography;8 cases of pulmonary embolism and subsequently confirmed by biochemical tests and CT angiography;Another two cases of chest pain patients,echocardiography showed no abnormal changes： One patient were confirmed as acute cholecystitis with stones,and the other patient was discharged after chest pain,a natural ease.Conclusion：Emergency echocardiography played a crucial role in diagnosis and differential diagnosis of acute chest pain as the preferred screening tool.