胸痛中心对主动脉夹层诊断的影响分析

Analysis of the Influence of the Diagnosis of Aortic Dissection of Chest Pain Center

目的探讨胸痛中心对主动脉夹层诊断的影响分析。方法回顾性分析2016年1月-2018年12月进入罗定市人民医院诊治的主动脉夹层患者57例,按照是否进入胸痛中心进行诊疗分为A组(进入胸痛中心诊疗,29例)、B组(未进入胸痛中心诊疗,28例),比较两组各个时间节点用时以及死亡率、漏诊率、误诊率。结果 A组首次心电图(EKG)检测用时、心肌肌钙蛋白(CTN)检测用时、主动脉增强CTA完成用时、诊断用时及接受治疗用时均少于B组,差异有统计学意义(t=13.144、37.638、28.489、32.351、14.390,P均=0.000);A组误诊率6.89%(2/29)、漏诊率3.45%(1/29)、主动脉夹层破裂发生率3.45%(1/29)、院内死亡率6.89%(2/29)、半年内死亡率10.34%(3/29)均低于B组的32.15%(9/28)、28.57%(8/28)、28.57%(8/28)、32.15%(9/28)、35.71%(10/28),差异有统计学意义(P<0.05)。结论胸痛中心能减少主动脉夹层患者检测以及诊断用时,降低其漏诊、误诊、破裂率以及死亡率,利于改善预后。

Objective To investigate the effect of the diagnosis of aortic dissection of chest pain center. Methods 57 patients with aortic dissection in the hospital from January, 2017 to December, 2018 were divided into group A(29 cases) and group B(28 cases) according to whether they entered the chest pain center. Time of each point, mortality, missed diagnosis rate and misdiagnosis rate of two groups were compared. Results The time of first electrocardiogram(EKG) detection, cardiac troponin(CTN) detection, aortic enhancement CTA completion, diagnosis time and treatment were lower in group A than in group B. The difference was statistically significant(t=13.144, 37.638, 28.489, 32.351, 14.390,P=0.000). The misdiagnosis rate of group A was 6.89%(2/29), the rate of missed diagnosis was 3.45%(1/29), the incidence of aortic dissection was 3.45%(1/29), the in-hospital mortality rate was 6.89%(2/29), and the mortality rate within the first half of the year was 10.34%(3/29), which was lower than the 32.15%(9/28), 28.57%(8/28),28.57%(8/28), 32.15%(9/28) and 35.71%(10/28) of the B group. The difference was statistically significant(P<0.05). Conclusion The chest pain center can reduce the diagnosis, misdiagnosis, and diagnosis of aortic dissection, and improve the prognosis.