急诊胸痛综合风险评估量表在急诊高危胸痛患者诊治中的应用价值

Application value of emergency chest pain comprehensive risk assessment scale in the diagnosis and treatment of patients with high-risk chest pain

目的探讨急诊高危胸痛患者采用急诊胸痛综合风险评估量表的临床应用价值。方法126例急诊高危胸痛患者,按诊断流程不同分为观察组(67例)与对照组(59例)。对照组采用常规诊断流程,观察组采用改良版(Sanchis版)急诊胸痛综合风险评估量表分诊救治。比较两组患者急诊科停留时间、确诊时间、误诊率、并发症发生情况及病死率。结果观察组急诊科停留时间(86.13±28.17)min及确诊时间(78.65±26.45)min均短于对照组的(116.85±13.52)、(106.52±13.21)min,而误诊率4.48%明显低于对照组的15.25%,差异具有统计学意义(P<0.05)。观察组患者的心源性休克、恶性心律失常、急性心力衰竭、肺梗死、心脏压塞发生率及病死率均明显低于对照组,差异具有统计学意义(P<0.05)。结论急诊高危胸痛患者采用急诊胸痛综合风险评估量表有着积极意义,可缩短急诊科停留及确诊时间,能减少误诊率及降低患者并发症发生率和病死率,具有较高的价值。

Objective To discuss the clinical value of emergency chest pain comprehensive risk assessment scale in the diagnosis and treatment of patients with high-risk chest pain.Methods A total of 126 patients with high-risk chest pain were divided into observation group(67 cases)and control group(59 cases)according to different diagnosis process.The control group received routine diagnosis process,and the observation group received modified version(Sanchis version)emergency chest pain comprehensive risk assessment scale for diagnosis and treatment.The emergency department length of stay,diagnostic time,misdiagnosis rate,occurrence of complications and mortality rate were compared between the two groups.Results The emergency department length of stay(86.13±28.17)min and diagnostic time(78.65±26.45)min of the observation group were shorter than(116.85±13.52)and(106.52±13.21)min of the control group,and misdiagnosis rate 4.48%was obviously lower than 15.25%of the control group.All the difference was statistically significant(P<0.05).The incidence of cardiogenic shock,malignant arrhythmia,acute heart failure,pulmonary infarction,cardiac tamponade and mortality rate of the observation group were obviously lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Emergency chest pain comprehensive risk assessment scale has positive significance for patients with high-risk chest pain,and it can shorten emergency department length of stay and diagnostic time,reduce misdiagnosis rate,lower incidence of complications and mortality rate.It contains high value.