【摘要】 目的探讨多联指标分析法对急诊急性主动脉夹层识别和诊断价值。方法回顾性分析32例急性主动脉夹层患者的多项临床资料,分析多联指标分析法诊断急性主动脉夹层的可靠性。结果符合指标1(胸痛、腹痛和背痛,伴坐卧不安躁动感)的患者有28例,符合指标2(休克样表现)为26例,符合指标3(双侧血压差)为21例,符合指标4(神经体征)为8例,符合指标5(D-二聚体升高)为29例,符合指标6(胸片纵隔增宽)为18例。32例患者多指标分析得分与确诊例数中3分的患者占最大比例,4分其次。得分为3分患者中,指标1+指标2+指标5的组合确诊率最高,指标1+指标3+指标5次之。结论运用多联指标分析法能对急诊急性主动脉夹层进行快速高效的诊断,可靠性高,为对后续诊治和降低医疗风险有重要意义,对一线医师尤其是基层医师具有极高的临床意义。更多还原

【Abstract】 Objective To explore the identification of mult-index analysis for acute aortic dissection and its diagnostic value. Methods Clinical data of 32 acute aortic dissection patients were retrospectively analyzed, and analysis was made on reliability of mult-index analysis for acute aortic dissection. Results 28 patients were in accord with index 1(chest pain, abdominal pain and back pain, complicated with restless feeling), 26 patients in accord with index 2(shock), 21 cases in accord with index 3(blood pressure difference on both sides), 8 patients in accord with index 4(neurologic signs), 29 patients in accord with index 5(rising D-dimer), and 18 patients in accord with index 6(widened chest radiograph mediastinum). 3 points patients of multi-index analysis score and diagnosed cases accounted for the largest proportion in 32 patients, followed by 4 points. In 3 points patients, combination of index 1 + index 2 + index 5 had the highest diagnostic rate, followed by index 1 + index 3 + index 5. Conclusion Application of multi-index analysis can make quick and efficient diagnosis for the emergency treatment of acute aortic dissection with high reliability, which provides important significantce for follow-up treatment and decline of medical risk, and it also have high clinical significance for first-tier physicians, especially basic level physicians.更多还原