摘要
目的探讨AD误诊为ACS行急诊介入手术的原因,并提出防范措施。方法对本院2017年9月-2022年7月收治被误诊为ACS的15例AD患者行急诊冠脉介入手术的病例资料,行回顾性分析。结果D-二聚体升高15例,cTNI升高10例,心电图异常12例,主动脉CTA示Stanford A型12例,Stanford B型3例。冠脉造影示:多支或单支冠脉血管病变11例,正常冠脉4例。结论对于胸痛合并心电图改变的患者,应详细询问病史,全面查体,结合D-二聚体、心肌酶、超声心动图等结果进行甄别,必要时行主动脉CTA等影像学检查明确诊断,减少误诊误治的发生。
Objective To explore the causes of the misdiagnosis of aortic dissection(AD)as acute coronary syndrome(ACS)in emergency interventional surgery,and put forward preventive measures.Methods Retrospective analysis was performed on the data of 15 patients with AD who were misdiagnosed as ACS and underwent emergency coronary intervention surgery in our hospital from September 2017 to July 2022.Results There were 15 cases D-dimer increased,10 cases cTNI increased,12 cases with abnormal ECG,total aortic CTA showed Stanford type A in 12 cases and Stanford type B in 3 cases.Coronary angiography showed that 11 cases of multiple or single vessel coronary lesions,and 4 cases of normal coronary artery.Conclusions Patients with chest pain and ECG changes,a detailed medical history should be asked,comprehensive physical examination are necessary,and identify with D-dimer,myocardial enzymes and echocardiography.If necessary,imaging examinations such as total aortic CTA should be performed as soon as possible to confirm the diagnosis to reduce the occurrence of misdiagnosis and mistreatment.
作者
苏瑞
胡勇
张荣华
SU Rui;HU Yong;ZHANG Ronghua(Department of Emergency,Fuwai Yunnan cardiovascular Hospital,Kunming Yunnan 650102,China)
出处
《云南医药》
CAS
2023年第4期22-25,共4页
Medicine and Pharmacy of Yunnan
关键词
主动脉夹层
误诊
急性冠脉综合征
急诊介入
aortic dissection
misdiagnosis
acute coronary syndrome
emergency intervention
