【摘要】 目的探讨急诊主动脉夹层(AD)诊断策略及误诊原因。方法回顾性分析我院急诊就诊的AD患者48例,对误诊例数、实验室检查结果、症状体征等临床资料进行分析。结果首诊确诊30例,误诊为心肌梗死4例,胰腺炎4例,胆囊炎3例,肠梗阻3例,泌尿系统结石3例,检查过程中死亡1例,入院后经相关科室检查确诊17例。结论 AD误诊率高,急诊医生对无明确原因的胸痛、腹痛应提高警惕;拓宽诊断思路,分析疼痛程度与诊断是否相符,借助实验室及影像学检查,提高AD的诊断率。更多还原

【Abstract】 Objective To explore the causes of misdiagnosis and early diagnostic strategy for acute aortic dissection(AD).Methods A retrospective analysis of 48 patients with AD and emergency department of our hospital patients,analyze clinical data of misdiagnosis cases,symptoms and signs,laboratory test.Results 30 cases were first diagnosed,misdiagnosed as acute myocardial infarction in 4 cases,4 cases of pancreatitis,3 cases of cholecystitis,3 cases of intestinal obstruction,3 cases of urinary calculi,1 patients died during the inspection,after admission to the relevant departments of examination in 17 cases.Conclusion AD misdiagnosis rate is high,the emergency doctor on chest and back,abdominal pain without clear reasons should be vigilant;broaden the diagnosis,analysis and diagnosis is consistent with the degree of pain,with the aid of laboratory and imaging tests,to improve the diagnostic rate of AD.更多还原