即时床旁超声心动图在诊断急性高危胸痛病人中的应用

Application of Immediate Bedside Echocardiography in Diagnosis of Patients with Acute High-risk Chest Pain

目的:总结即时床旁经胸超声心动图(TTE)在急性高危胸痛患者诊断中的应用。方法:回顾性分析2019年3月至2021年5月广东省河源市人民医院诊治的244例急性胸痛患者的临床资料,并分为急性高危胸痛组63例,非急性高危胸痛组181例(对照组),比较TTE的诊断率及其在不同病因胸痛中的检测指标。结果:TTE诊断急性高危胸痛的检出率为90.5%,明显高于心电图(ECG)检出率的69.8%,P<0.05;急性心肌梗死(AMI)、主动脉夹层(AD)患者的左室舒张末容积、左室射血分数(LVEF)及AD患者的升主动脉直径与对照组均有明显差异,肺栓塞(PE)患者的右室舒张末期容积和三尖瓣环收缩期运动幅度(TAPSE)与对照组有明显差异,P均<0.05。结论:即时床旁TTE能及时快速有效辅助诊断常见急性高危胸痛,建议临床推广应用。

Objective:To summarize the application of immediate bedside transthoracic echocardiography(TTE)in the diagnosis of patients with acute high-risk chest pain. Methods:Theclinical data of 244 patients with acute chest pain in the hospital from Mar 2019 to May 2021 wereanalyzed retrospectively,and the cases were classified as with highrisk acute chest pain group(n=63)and non-high-risk acute chest pain group(control group,n=181). The diagnostic rate of TTE and the examine index on various cause of acute chest pain were compared. Results:The diagnostic rate of63 patients with acutehigh-risk chest pain by TTE was significantly higher than that by ECG(90.5% vs 69.84%,P<0.05). Compared with the control group,the left ventricular end-diastolic volumeand LVEFin patients with acute myocardial infarction(AMI)andaortic dissection(AD)was significantly different,and the diameter of ascending aorta in AD was significantly different also. The right ventricular end-diastolic volume of pulmonary embolism(PE)and TAPSE was statistically significant compared with the control group(P<0.05). Conclusion:Immediate bedside TTE is an effective examination method for patients with high risk chest pain,and is worth of popularization and application.