急性心肌梗死首诊误诊26例临床分析

Clinical Analysis of 26 Misdiagnosed Patients with Acute Myocardial Infarction

目的:探讨基层医院急性心肌梗死(AMI)误诊原因及防范对策,以提高对AMI的认识和诊治水平。方法:回顾性分析2010年6月-2014年6月我院门急诊首诊误诊的26例AMI患者的临床资料。结果:误诊为呼吸系统疾病9例,其他心血管疾病8例,消化道疾病6例,泌尿系结石肾绞痛、颈椎病、肩周炎各1例;5例在门急诊发生猝死。结论:AMI的临床表现复杂多样,容易误诊,加强对AMI的认识,规范诊疗过程,可提高其诊治水平,降低误诊率及死亡率。

Objective：To explore the misdiagnosis causes and prevent measures of patients with acute myocardial infarction （AMI） in basic hospital to improve the cognition and the levels of diagnosis and treatment of AMI. Method： The clinical data of 26 misdiagnosed patients with AMI were analyzed retrospectively from Jun 2010 to Jun 2014 in the department of out-patient and emergency. Results：Among the 26 cases,9 cases were misdiagnosed as respiratory system diseases,8 cases were misdiagnosed as other cardiovascular diseases, 6 cases were misdiagnosed as digestive diseases, and 1 case was misdiagnosed as urinary stone, neck and shoulder disease respectively. 5 patients with misdiagnosed AMI were sudden death at department of out-patient and emergency. Conclusion：It is complication to symptoms of patients with AMI and to misdiagnosis easily. Enhancing the realization and standardizing process of the diagnosis and treatment may raise the levels of the diagnosis and treatment and decrease the rate of misdiagnosis and death of AMI.