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Assessment of systemic immune-inflammatory index and other inflammatory parameters in predicting mortality in patients with acute cholecystitis:A retrospective observational study
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作者 İbrahim Korkmaz Burak Peri Rezan Karaali 《Journal of Acute Disease》 2024年第4期150-156,共7页
Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients prese... Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients presented to the emergency department with abdominal pain and diagnosis of AC between September 2021 and September 2023 were included in the study.Demographic data,laboratory parameters,clinical follow-ups,and outcomes of the patients were recorded.Results:The mean age of the patients was(55.0±16.3)years and 36.6%were male.63.8%Had gallbladder/choledochal stones and 49.5%underwent surgery.The mortality rate was 6.1%.Advanced age(P=0.170)and prolonged hospitalization(P=0.011)were statistically significant risk factors for mortality.Decreased lymphocyte count(P=0.020)and increased C-reactive protein(CRP)levels(P=0.033)were found to be risk factors for mortality.According to the mortality predictor ROC analysis results,the cut-off for SII index was 3138(AUC=0.817,sensitivity=70.5%,specificity=84.7%),the cut-off for neutrophil count was 15.28×10^(3)/mm^(3)(AUC=0.761,sensitivity=52.9%,specificity=95.0%),the cut-off for leukocyte count was 19.0×10^(3)/mm^(3)(AUC=0.714,sensitivity=52.9%,specificity=98.0%),cut-off for CRP was 74.55(AUC=0.758,sensitivity=70.5%,specificity=79.0%),cut-off for aspartate transaminase(AST)was 33.0 IU/L(AUC=0.658,sensitivity=82.3%,specificity=50.3%).Conclusions:The SII index may be a good predictor of mortality with high sensitivity and specificity.Elevated levels of neutrophils,leukocytes,CRP,and AST are other inflammatory parameters that can be used to predict mortality associated with AC. 展开更多
关键词 abdominal pain acute cholecystitis Systemic immune-inflammatory index MORTALITY inflammation emergency department
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Evaluation of the Use of Ketamine for Acute Pain in the Emergency Department at a Tertiary Academic Medical Center
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作者 Nahal Beik Katelyn Sylvester +1 位作者 Megan Rocchio Michael B. Stone 《Pharmacology & Pharmacy》 2016年第1期19-24,共6页
Introduction: At subdissociative doses of 0.1 - 0.5 mg/kg, ketamine provides effective analgesia when used alone or as an adjunct to opioid analgesics without causing cardiovascular or respiratory compromise. Ketamine... Introduction: At subdissociative doses of 0.1 - 0.5 mg/kg, ketamine provides effective analgesia when used alone or as an adjunct to opioid analgesics without causing cardiovascular or respiratory compromise. Ketamine is a beneficial analgesic agent in the emergency department (ED), particularly in patients with opioid-resistant pain or polytrauma patients who are hemodynamically unstable. Purpose: The purpose of this study was to evaluate current practice and describe clinical outcomes associated with the use of low-dose ketamine for acute pain in the ED. Methods: Adult patients receiving ketamine were retrospectively evaluated between March 1, 2012 and March 31, 2013. Patients were included if they were ordered for ketamine in the ED to treat acute pain. Outcomes included dose administered, cumulative doses, concurrent opioid administration, and any efficacy or adverse events documented after the administration of ketamine. Continuous variables are reported as mean (standard deviation [SD]) or median (interquartile range [IQR]). Results: A total of 46 patients were evaluated for inclusion. Of the 25 patients included, 38 doses of ketamine were documented. The mean age was 41 years old with 64% of the patients being female. The average initial ketamine dose was 0.12 ± 0.06 mg/kg and 8 (32%) patients received multiple doses of ketamine (1.5 ± 0.8 doses per patient). Ketamine was added to opioid therapy in 23 (92%) patients. Pain scores decreased post administration of ketamine from 10 (9 - 10) to 5 (4 - 7). Adequate pain relief was documented in 11 (44%) patients (felt comfortable going home);partial pain relief was noted in 5 (20%) patients;3 (12%) patients reported no pain relief;3 (12%) patients were able to have a procedure done, and efficacy was not documented in 3 (12%) patients. Anxiety and agitation were documented in 2 (8%) patients. No adverse outcomes were documented in 84% of patients. Conclusion: Administration of low-dose ketamine for acute pain in the ED demonstrated improvement in patients’ pain scores with minimal documented adverse outcomes. 展开更多
关键词 KETAMinE acute pain emergency department
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Analysis on the Clinical Effects of Emergency Surgical Treatment on Patients with Acute Abdominal Pain
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作者 Xuan Hu 《Journal of Clinical and Nursing Research》 2021年第1期33-35,共3页
Objective:To study the clinical effects of emergency surgery in treating patients with acute abdominal pain.Methods:60 patients admitted to our hospital between January 2019 and December 2019 were randomly selected as... Objective:To study the clinical effects of emergency surgery in treating patients with acute abdominal pain.Methods:60 patients admitted to our hospital between January 2019 and December 2019 were randomly selected as subjects,and the incidence of complications and mortality of the patients were observed.Results:Among the 60 patients,definitive diagnosis was obtained during the operation and there was no mortality.After the operation,they were transferred to other relevant departments for continued treatment.Among the 60 patients,4 cases had complications,accounted for incidence of 6.67%.Conclusion:The diagnosis of emergency surgical treatment based on acute abdominal pain avoided misdiagnosis and realized non-invasive diagnosis,and provided a valid reference for avoiding overtreatment. 展开更多
关键词 emergency surgery acute abdominal pain Clinical effect
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Performance of the EDACS-ADP incorporating high-sensitivity troponin assay:Do components of major adverse cardiac events matter?
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作者 Yedalm Yoo Shin Ahn +1 位作者 Bora Chae Won Young Kim 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第3期175-180,共6页
BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients ... BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and II,respectively).METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value.RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6%;95%confidence interval[95%CI]:27.7%–33.8%)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I and II were 1.3%(5/399)and 1.0%(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8%(95%CI:97.2%–99.6%)and 98.7%(95%CI:97.0%–99.5%)for MACE I and 98.7%(95%CI:96.8%–99.7%)and 99.0%(95%CI:97.4%–99.6%)for MACE II,respectively.CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated lowrisk patients remained above the level acceptable for early discharge without further evaluation. 展开更多
关键词 Chest pain Major adverse cardiac event acute coronary syndrome emergency department
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A single subcutaneous dose of tramadol for mild to moderate musculoskeletal trauma in the emergency department 被引量:2
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作者 Alejandro Cardozo Carlos Silva +3 位作者 Luis Dominguez Beatriz Botero Paulo Zambrano Jose Bare?o 《World Journal of Emergency Medicine》 CAS 2014年第4期275-278,共4页
BACKGROUND: Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the percep... BACKGROUND: Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection.METHODS: A total of 77 patients, who met inclusion criteria, received a single subcutaneous dose of tramadol. Pain control was evaluated based on the verbal numerical pain scale(0–10) at baseline, 20 and 60 minutes; similarly, pain perception was evaluated secondary to subcutaneous injection of the analgesic.RESULTS: On admission, the average pain perceived by patients was 8; twenty minutes later, 89% of the patients reported fi ve or less, and after sixty minutes, 94% had three or less on the verbal numerical pain scale. Of the patients, 88% reported pain perception by verbal numeric scale of 3 or less by injection of the drug, and 6.5% required a second analgesic for pain control. Two events with drug administration(soft tissue infection and mild abdominal rectus injection) were reported.CONCLUSION: We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department. 展开更多
关键词 TRAMADOL ANALGESIC routes SUBCUTANEOUS acute pain emergency department
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A retrospective study of patients complaining of nontraumatic acute abdominal pain,admitted in the emergency department of an urban hospital in China
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作者 Guanguan Luo Qinqin Liu +1 位作者 Zhongxiang Zhang Xiaoqing Jin 《Emergency and Critical Care Medicine》 2023年第4期149-155,共7页
Background:Nontraumatic acute abdominal pain(AAP)accounts for a large proportion of emergency department(ED)admissions.This study aimed to explore the underlying correlations among basic information,imaging examinatio... Background:Nontraumatic acute abdominal pain(AAP)accounts for a large proportion of emergency department(ED)admissions.This study aimed to explore the underlying correlations among basic information,imaging examinations,and diagnoses.Methods:A total of 7453 patients complaining of AAP,admitted to the ED of Zhongnan Hospital of Wuhan University,were enrolled in this retrospective study from January 1 to December 30,2019.We collected the following information from the patients:sex,age,date of visit,pain location,nature of pain,level of severity,imaging(computed tomography,x-ray,and ultrasound),diagnosis,and outcomes(re-lease from the hospital,transfer to another hospital,transfer to another department,observation room,hospitalization,or death).Results:According to this study,AAP was more common in female than male.A total of 82.11%patients of AAP were in level 3 of se-verity,while 0.19%patients were in level 1.A total of 77.20%of the patients had undergone imaging.Swelling pain and colic are the 2 most common types of AAP.Nonspecific abdominal pain(NSAP)is the most common diagnosis.In the diagnosis of NSAP and gastroenteritis,female patients were more prevalent than male patients,but for renal colic,male patients were 3 times as many as female patients.Non-specific abdominal pain,biliary colic,and cholecystitis are the 3 leading causes in patients 65 years or older.Nonspecific abdominal pain,renal colic,and gastroenteritis are the 3 leading causes of AAP in patients younger than 65 years.Conclusion:With the help of imaging,clinicians can specify a diagnosis and perform corresponding treatment in most cases.However,making a precise diagnosis of AAP within a short period is still challenging.Further research should be conducted to seek safer and more effective techniques to streamline clinicians’work. 展开更多
关键词 abdominal pain DIAGNOSIS emergency department EPIDEMIOLOGY GASTROENTEROLOGY
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A Qualitative Study of the Triage of Patients with Non-Traumatic Acute Abdomen
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作者 Zhongqing Yang Juqing Ke Huandi Zhao 《Journal of Clinical and Nursing Research》 2023年第4期79-88,共10页
Objective: To explore the work experience of medical staff in the emergency department of a general hospital in the triage of patients with non-traumatic acute abdomen to formulate corresponding intervention measures ... Objective: To explore the work experience of medical staff in the emergency department of a general hospital in the triage of patients with non-traumatic acute abdomen to formulate corresponding intervention measures and branch evaluation tools. Methods: With descriptive phenomenology as the research method, semi-structured interviews were conducted with the medical staff in a tertiary hospital in Nanjing from February 1st to 10th, 2023, and Colaizzi seven-step analysis was used to analyze the data. Results: A total of 17 emergency medical staff were interviewed in this study. Four themes were derived from the analysis of the data: the etiology of acute abdomen is complex, so it is difficult to categorize them: acute abdomen requires immediate treatment, but the treat will be delayed if the categorization is inaccurate;the high pressure of nurses and the accuracy in categorizing the patients are problems that should be addressed. Conclusion: The categorization of patients with non-traumatic acute abdomen is challenging. Therefore, it is necessary to carry out corresponding intervention and formulate appropriate departmental evaluation tools to improve the accuracy of categorization of patients with acute abdomen. 展开更多
关键词 emergency department Non-traumatic acute abdomen abdominal pain TRIAGE Medical staff Qualitative research
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Nociceptive and Neuropathic Pain Qualities in Men and Women with Acute Coronary Syndromes: A Complex Pain Presentation
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作者 Sheila O’Keefe-McCarthy Michael McGillion +2 位作者 Charles J. Victor Sheila Rizza Judith McFetridge-Durdle 《Open Journal of Nursing》 2017年第3期331-344,共14页
Background: Cardiac pain arising from acute coronary syndrome (ACS) is a multi-factorial phenomenon. Historically, episodes of cardiac pain have been captured using a one-dimensional numeric pain rating scale. Lacking... Background: Cardiac pain arising from acute coronary syndrome (ACS) is a multi-factorial phenomenon. Historically, episodes of cardiac pain have been captured using a one-dimensional numeric pain rating scale. Lacking in clinical practice are acute pain assessments that employ a comprehensive evaluation of an emergent ACS episode. Aim: To examine the sensory-discriminative, motivational-affective and cognitive-evaluative dimensions of ACS-related pain. Methods: A descriptive-correlational, repeated-measure design was used to collect data on 121 ACS patients of their cardiac pain intensity. The (numeric rating scale-NRS 0-10 scale) measured chest pain “Now” and “Worst pain in the previous 2 hours over 8 hours” and the McGill Pain Questionnaire Short-Form (MPQ-SF) measured pain at 4 hours. Results: Mean age was 67.6 ± 13, 50% were male, 60% had unstable angina and 40% had Non-ST-elevation myocardial infarction. Cardiac pain intensity scores remained in the mild range from 1.1 ± 2.2 to 2.4 ± 2.7. MPQ-SF: 66% described pain as distressing and 26% reported pain was horrible or excruciating. Participants described ACS pain quality as acute injury (nociceptive pain: heavy, cramping, stabbing), as nerve damage (neuropathic: gnawing, hot-burning, shooting) and as a mixture of acute and chronic pain qualities (aching, tender and throbbing). Conclusions: Patients reported both nociceptive and neuropathic cardiac pain. It is unclear if pain perceptions are due to: i) pathophysiology of clot formation, ii) occurrence of a first or repeated ACS episode, or iii) complex co-morbidities. Pain arising from ACS requires an understanding of the interplay of ischemic, metabolic and neuropathophysiological mechanisms that contribute to complex cardiac pain experiences. 展开更多
关键词 acute CORONARY SYNDROMES NOCICEPTIVE pain NEUROPATHIC pain pain DESCRIPTORS emergency department
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急性胸痛患者早期风险评估研究进展
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作者 高洁 宋东丽 +8 位作者 刘胜囡 崔维凯 王玉婷 王怡帆 边圆 尹心心 蒋丽军 王甲莉 陈玉国 《中国医药》 2024年第10期1563-1567,共5页
急性胸痛是急诊常见的症状之一,早期精准识别高风险性和低风险性胸痛有益于高危患者得到及时诊疗以及低危患者减少过度医疗,同时改善预后和缓解院前急救及急诊科医疗资源的严峻。近年来急性胸痛患者早期危险分层工具不断开发,其敏感度... 急性胸痛是急诊常见的症状之一,早期精准识别高风险性和低风险性胸痛有益于高危患者得到及时诊疗以及低危患者减少过度医疗,同时改善预后和缓解院前急救及急诊科医疗资源的严峻。近年来急性胸痛患者早期危险分层工具不断开发,其敏感度和特异度各有不同。本文对目前急性胸痛患者早期风险评估的研究进展进行综述。 展开更多
关键词 急性胸痛 早期风险评估 急诊科 院前急救
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Establishment and Application of Early Risk Stratification Method for Acute Abdominal Pain in Adults 被引量:2
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作者 Yu Wang Hong Zhao +3 位作者 Zhen Zhou Ci Tian Hong-Li Xiao Bao-En Wang 《Chinese Medical Journal》 SCIE CAS CSCD 2017年第5期530-535,共6页
Background: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratifica... Background: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would gnide physicians to take appropriate and timely measures following the established health-care policies. Methods: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study. Measurement data and numeration data were compared with analysis of variance and Chi-square test, respectively. Multiple regression analysis calculated odd ratio (OR) value. P and OR values showed the impacts of factors. ERSM was established by clinical experts and statistical experts according to Youden index. In Cohort 2, data from 305 patients with acute abdominal pain were enrolled to validate the accuracy of the ERSM. Then, ERSM was prospectively used in clinical practice. Results: The ERSM was established based on the scores of the patient's clinical characteristics: right lower abdominal pain + 3 × diffuse abdominal pain + 3 ×cutting abdominal pain + 3 × pain frequency + 3 × pain duration + fever + 2 × vomiting + 5 × stop defecation + 3 - history of abdominal surgery + hypertension history + diabetes history + hyperlipidemia history + pulse + 2 - skin yellowing + 2 × sclera yellowing + 2 × double lung rale + 10 × unconsciousness + 2 ×right lower abdominal tenderness + 5 x diffuse abdominal tenderness + 4 x peritoneal irritation + 4 × bowel sounds abnormal + 10 × suspicious diagnosis + white blood cell count + hematocrit + glucose + 2 × blood urea nitrogen + 3 × creatine + 4× serum albumin + alanine aminotransferase + total bilirubin + 3 × conjugated bilirubin + amylase. When the score was 〈18, the patient did not need hospitalization. A score of≥18 and 〈38 indicated that the patient should be under observation or hospitalized. A score of≥38 and 〈50 indicated the need for an emergent operation. A score of≥50 indicated the need for admission to the Intensive Care Unit. The area under the receiver operating characteristic curve of the ERSM in Cohorts 1 and 2 were 0.979 and 0.988, respectively. Conclusions: This ERSM was an accurate and reliable method for making an early determination of the severity of acute abdominal pain. There was the strong correlation between scores of ERSM and health-care decision-making. 展开更多
关键词 acute abdominal pain emergency Risk Factor STRATIFICATION
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急性胸痛发病的Logistic多因素分析 被引量:1
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作者 杨蕙萍 刘雪松 庞卫锋 《系统医学》 2023年第16期34-37,共4页
目的探讨急性胸痛发病的影响因素。方法选择2020年1月—2022年12月常州市第七人民医院急诊科收诊急性心肌梗死患者158例作为观察目标进行回顾性分析,按照患者是否并发胸痛进行分组,即胸痛发病组(113例)和非胸痛发病组(45例),所有患者均... 目的探讨急性胸痛发病的影响因素。方法选择2020年1月—2022年12月常州市第七人民医院急诊科收诊急性心肌梗死患者158例作为观察目标进行回顾性分析,按照患者是否并发胸痛进行分组,即胸痛发病组(113例)和非胸痛发病组(45例),所有患者均收集其一般资料,并通过单因素及Logistic回归分析急性胸痛发病的影响因素。结果根据单因素结果数据分析显示,胸痛发病组D二聚体(D-Dimer,D-D)(860.35±190.17)ng/mL、血清肌酸激酶同工酶(creatine kinase-MB,CK-MB)(7.02±1.29)ng/mL、肌红蛋白(myoglobin,MYO)(98.55±20.02)μg/L、肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnⅠ)(1.96±0.54)μg/L 4项指标与非胸痛发病组比较,差异有统计学意义(t=38.248,22.078,26.113,33.294,P<0.05);多因素分析结果显示,D-D、CK-MB、MYO、cTnⅠ均为急性胸痛发病的独立危险因素(OR=2.143、3.674、1.895、3.753,P<0.05)。结论血浆D-二聚体、血清肌酸激酶同工酶、肌红蛋白、肌钙蛋白Ⅰ是急性心肌梗死发病的独立危险因素,通过深入分析其影响因素,可以更好地识别高风险患者,并在早期采取必要的干预措施,以减少不良事件的发生。 展开更多
关键词 急诊科 急性胸痛 病因诊断 作用
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基层医院急诊夜间急性腹痛临床效果观察 被引量:1
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作者 马德勇 《罕少疾病杂志》 2023年第7期76-77,共2页
目的为了深入研究对急性腹痛患者实施优质急诊干预后,患者临床疗效、症状改善情况、自我管理评分、生活质量及疼痛评分。方法选取我院2021年8月至2022年8月期间收治的急性腹痛患者共98例,研究组给予优质急诊,参照组给予常规急诊。对比... 目的为了深入研究对急性腹痛患者实施优质急诊干预后,患者临床疗效、症状改善情况、自我管理评分、生活质量及疼痛评分。方法选取我院2021年8月至2022年8月期间收治的急性腹痛患者共98例,研究组给予优质急诊,参照组给予常规急诊。对比两组临床效果。结果干预后,研究组91.8%的临床疗效显著优于参照组67.35%的临床疗效;研究组症状改善显著较优;研究组自我管理评分显著较优;研究组生活质量改善情况显著较优;研究组疼痛评分显著较低。差异具有统计学意义,(P<0.05)。结论临床对急性腹痛患者实施优质急诊干预,可有效改善患者临床疗效、症状改善情况、自我管理评分、生活质量及疼痛评分,故方案值得推广。 展开更多
关键词 基层医院 急诊夜间急性腹痛 临床效果
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HEART评分对急诊科急性胸痛患者30天心血管不良事件预测价值 被引量:26
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作者 黄振华 詹红 +4 位作者 肖孝勇 叶子 蒋鹏 蔡锐彬 廖瑾莉 《实用医学杂志》 CAS 北大核心 2017年第14期2341-2344,共4页
目的评价HEART评分对急性胸痛患者30 d心血管不良事件(MACE)的预测价值。方法使用前瞻性观察研究的方法,收集2016年1-4月在我院急诊科就诊的急性胸痛患者,并对纳入的患者进行30 d心血管不良事件的随访。结果本研究纳入209例患者,平均(65... 目的评价HEART评分对急性胸痛患者30 d心血管不良事件(MACE)的预测价值。方法使用前瞻性观察研究的方法,收集2016年1-4月在我院急诊科就诊的急性胸痛患者,并对纳入的患者进行30 d心血管不良事件的随访。结果本研究纳入209例患者,平均(65.28±16.85)岁,男110例(52.63%),MACE组患者年龄、高血压、ACS比率、SpO_2、需要住院、HEART评分高于非MACE组,2组比较差异具有统计学意义(P<0.05);MACE组患者入院血压(收缩压、舒张压)低于非MACE组,2组比较差异具有统计学意义(P<0.05);30 d随访发生心血管不良事件概率为5.74%,HEART评分对30 d心血管不良事件的发生有良好的预测价值,ROC曲线下面积为0.908(95%CI 0.846~0.974),不同HEART评分危险分层30 d心血管不良事件概率分别为0~3分(0)、4~6分(2.5%)、7~10分(27%)。结论 HEART评分能简单、快速、准确的预测急性胸痛患者30 d内MACE,有效排除低危胸痛患者MACE,对急诊科快速病情评估和诊治过程起到非常重要的作用。 展开更多
关键词 HEART评分 急性胸痛 急诊科 心血管不良事件
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北京市气温对腹痛急诊日就诊人数的影响 被引量:6
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作者 蒋艳峰 王丽萍 +5 位作者 尹岭 李金斌 李旭 尚可政 李蓓 牛静萍 《兰州大学学报(自然科学版)》 CAS CSCD 北大核心 2015年第1期103-108,共6页
定量分析北京市气温对腹痛急诊日就诊人数的影响.收集2009-2012年北京市海淀区某三甲医院腹痛急诊资料和同期北京市气象、大气污染物资料,采用广义相加模型在控制时间、其他气象要素和大气污染物(SO2,NO2,PM10)的混杂效应下,拟合日均... 定量分析北京市气温对腹痛急诊日就诊人数的影响.收集2009-2012年北京市海淀区某三甲医院腹痛急诊资料和同期北京市气象、大气污染物资料,采用广义相加模型在控制时间、其他气象要素和大气污染物(SO2,NO2,PM10)的混杂效应下,拟合日均气温、最高温度、最低温度、气温日较差、24 h变温对腹痛急诊日就诊人数影响的剂量-反应关系.几项气温指标对腹痛急诊日就诊人数均有不同程度影响,日均气温、最高温度和最低温度每增加1℃,腹痛急诊日就诊的相对危险度RR分别为1.0052(95%CI:1.0034-1.0070),1.0049(95%CI:1.003 2-1.0066)和1.004 7(95%CI:1.002 9-1.006 5).温度日较差和24 h变温对腹痛急诊日就诊人数有正向的影响,但结果无统计学意义.研究结果表明腹痛急诊日就诊人数夏季较多,日均气温、最高温度和最低温度对其均有影响. 展开更多
关键词 腹痛 温度 急诊 广义相加模型 北京市
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GRACE评分对急诊胸痛患者30d和6个月主要不良心血管事件的预测价值 被引量:3
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作者 李敏 江慧琳 +5 位作者 李云妹 莫均荣 茅海峰 田朝伟 林飒仪 陈晓辉 《中国急救医学》 CAS CSCD 北大核心 2017年第12期1123-1128,共6页
目的探讨GRACE评分对急诊室胸痛患者30d和6个月主要不良心血管事件(MACE)的预测价值。方法前瞻性队列临床观察研究方法对2012—03—17—2013—08—14在我院急诊因急性胸痛首诊的、年龄≥18岁患者进行观察。记录患者临床资料、GRACE评... 目的探讨GRACE评分对急诊室胸痛患者30d和6个月主要不良心血管事件(MACE)的预测价值。方法前瞻性队列临床观察研究方法对2012—03—17—2013—08—14在我院急诊因急性胸痛首诊的、年龄≥18岁患者进行观察。记录患者临床资料、GRACE评分、30d和6个月MACE情况。结果纳入研究的493例急性胸痛患者,30d和6个月随访中,分别有32例(6%)和38例(7%)发生MACE。Logistic回归分析数据可见,GRACE评分、性别、吸烟史对急性胸痛患者30d和6个月的MACE发生有预测意义。GRACE评分预测胸痛患者30dMACE发生的曲线下面积(areaundercurve,AUC)为0.815(95%C10.778—0.849),Cutoff值为174分,而预测胸痛患者6个月死亡的AUC为0.807(95%C10.769~0.841),Cutoff值为173分。结论GRACE评分可以有效预测急诊急性胸痛患者30d和6个月是否发生MACE。 展开更多
关键词 急性胸痛 预测 GRACE评分 主要不良心血管事件(MACE) 急诊科
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绕行急诊科对行直接经皮冠状动脉介入治疗患者预后的影响 被引量:13
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作者 郭瑞威 杨丽霞 +2 位作者 木丽华 齐峰 刘浩 《中国介入心脏病学杂志》 2015年第11期622-625,共4页
目的回顾性分析绕行急诊科对行直接经皮冠状动脉介入治疗(PCI)患者30 d预后的影响。方法纳入2014年6月至2015年4月在成都军区昆明总医院心血管内科行直接PCI的急性心肌梗死患者174例。根据是否绕行急诊科分为绕行组(115例)和对照组(59... 目的回顾性分析绕行急诊科对行直接经皮冠状动脉介入治疗(PCI)患者30 d预后的影响。方法纳入2014年6月至2015年4月在成都军区昆明总医院心血管内科行直接PCI的急性心肌梗死患者174例。根据是否绕行急诊科分为绕行组(115例)和对照组(59例),收集患者基线资料,PCI过程相关数据,30 d主要不良心血管事件[MACE,包括死亡、再发心肌梗死和靶血管再次血运重建(TVR)]发生率。统计分析两组数据的变化情况。结果两组患者年龄、性别、高血压病史、糖尿病史、高脂血症史、多支病变、抽吸导管、支架长度、发病至入院时间(PTD)及肌酸激酶(CK)峰值等比较,差异均无统计学意义(均P>0.05),而绕行组患者门球时间(D2B)显著低于对照组[(67.7±21.5)min比(89.4±23.6)min,P<0.001];两组患者30 d死亡率、再发心肌梗死率和TVR发生率比较,差异均无统计学意义(均P>0.05),但绕行组患者总MACE发生率显著低于对照组(10.2%比1.7%,P=0.012);Logistic回归分析显示,年龄、糖尿病史、PTD、CK峰值是直接PCI后30d MACE发生的主要影响因素(P<0.05)。结论绕行急诊科可以缩短D2B时间,降低直接PCI后30 d的总MACE发生率,因此缩短总缺血时间将能给急性心肌梗死带来更大的益处。 展开更多
关键词 急性心肌梗死 直接经皮冠状动脉介入治疗 绕行急诊科 门球时间 胸痛中心
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急诊抢救室处理非创伤急性腹痛274例临床调查及分析 被引量:4
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作者 梁亚鹏 刘志祯 尹其翔 《当代医学》 2015年第28期3-5,共3页
目的对274例经急诊抢救室处理的非创伤急性腹痛患者临床资料进行回顾、总结、分析,强调对致命性非创伤急性腹痛的认识,提高抢救成功率。方法回顾急诊抢救室处理的274例以急性腹痛为主诉的非创伤患者的临床资料,对其病史、症状、体征、... 目的对274例经急诊抢救室处理的非创伤急性腹痛患者临床资料进行回顾、总结、分析,强调对致命性非创伤急性腹痛的认识,提高抢救成功率。方法回顾急诊抢救室处理的274例以急性腹痛为主诉的非创伤患者的临床资料,对其病史、症状、体征、辅助检查及最终诊断进行总结、分析。结果经急诊抢救室处理以急性腹痛为主诉的非创伤患者,可迅速致命的疾病占12.04%(33例),延误病情后果严重可能危及生命的疾病占16.42%(45例),两者相加占28.46%。结论经急诊抢救室处理的非创伤急性腹痛潜在危险性巨大,需高度重视鉴别诊断,重点排除致命性疾病,从而改善预后。 展开更多
关键词 急诊 抢救室 急性腹痛 致命性
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急诊外科17例急性腹痛误诊原因分析 被引量:5
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作者 秦卫东 何黎 屈纪富 《中国医药指南》 2010年第36期188-189,共2页
目的分析急诊外科诊治中急性腹痛误诊原因及应吸取的教训和防范对策。方法回顾性分析我院急诊外科2005年12月至2009年12月17例急性腹痛误诊病例临床资料。结果 17例误诊病例中,妇科疾病9例,外科疾病7例,内科疾病1例,手术治疗后确诊12例... 目的分析急诊外科诊治中急性腹痛误诊原因及应吸取的教训和防范对策。方法回顾性分析我院急诊外科2005年12月至2009年12月17例急性腹痛误诊病例临床资料。结果 17例误诊病例中,妇科疾病9例,外科疾病7例,内科疾病1例,手术治疗后确诊12例,会诊并做进一步检查后确诊5例。结论仔细全面询问病史,详细体格检查,必要辅助检查,知识面的扩宽是减少误诊的关键。 展开更多
关键词 急诊外科 急性腹痛 误诊
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脊髓损伤后急腹症临床特点的细化及机制分析 被引量:3
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作者 刘舒佳 陈振波 +3 位作者 于卫永 张军卫 刘介生 洪毅 《实用骨科杂志》 2019年第9期773-775,共3页
目的总结脊髓损伤患者急腹症的临床表现、体征特点,探讨诊断经验。方法对2010年1月至2019年2月在中国康复研究中心就诊的14岁以上脊髓损伤(spinal cord injury,SCI)患者的病历进行回顾性分析。结果全部4396名脊髓损伤患者中排除损伤水平... 目的总结脊髓损伤患者急腹症的临床表现、体征特点,探讨诊断经验。方法对2010年1月至2019年2月在中国康复研究中心就诊的14岁以上脊髓损伤(spinal cord injury,SCI)患者的病历进行回顾性分析。结果全部4396名脊髓损伤患者中排除损伤水平T12以下患者,共38例新发急腹症病例。急性胆囊炎相关疾病16例,肠梗阻15例,胰腺炎3例,阑尾炎2例,脏器穿孔破裂2例。脊髓损伤AIS分级A级25例,B级3例,C级8例,D级2例。首发症状为腹胀者24例,腹痛者17例,腹肌紧张者仅3例。脊髓损伤人群中胆囊炎发病率为0.36%,肠梗阻发病率为0.34%。严重急腹症4例:胃穿孔1例,小肠破裂1例,急性坏疽性胆囊炎2例。均无急腹症典型体征。结论通过急腹症常见经典表现及体征进行诊断不适用于高位脊髓损伤人群。急性胆囊炎是脊髓损伤患者急腹症最常见病因。脊髓损伤急腹症患者最常见主诉为腹胀,有腹痛表现者不足50%,腹肌紧张者鲜见。当脊髓损伤患者出现改变体位无法纠正的低血压、肌张力异常增高、漏尿量异常增加等情况时应想到腹腔脏器受损可能。影像学、实验室检查是提高脊髓损伤患者急腹症诊断率的有效手段。 展开更多
关键词 脊髓损伤 急腹症 内脏痛
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62例内科急诊急性腹痛患者的临床诊断分析 被引量:13
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作者 成忠凤 刘林 《中外医疗》 2015年第8期41-42,45,共3页
目的研究内科急诊急性腹痛患者的临床诊断方法以及种类。方法选取该院自2011年1月—2014年1月间收治的62例急性腹痛患者,采取资料回顾性分析,研究其急腹症疾病种类以及诊断方法。结果经过该院的诊断研究,急性胃肠炎20例,占32.26%,急慢... 目的研究内科急诊急性腹痛患者的临床诊断方法以及种类。方法选取该院自2011年1月—2014年1月间收治的62例急性腹痛患者,采取资料回顾性分析,研究其急腹症疾病种类以及诊断方法。结果经过该院的诊断研究,急性胃肠炎20例,占32.26%,急慢性胃炎22例,占35.48%,心肌梗死2例,占3.23%,消化性溃疡17例,占27.42%,尿毒症1例,占1.61%;就诊过程中常常使用的辅助检查为血常规、腹部CT、腹部B超、心电图、胃镜、腹腔穿刺、肾功能、肝功能检查。结论急性腹痛为临床的常见症状,医师在诊断的过程中需详细了解患者的病史,合理应用了各项检查手段,对患者进行准确、快速确定病因,使得患者获得及时的诊断时机,从根本上减少误诊。 展开更多
关键词 内科急诊 急性腹痛 临床诊断 种类
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