【摘要】 目的评估床旁心肺快速超声联合D-二聚体检测在胸痛救治单元中应用效果。方法 127例急性胸痛患者分为研究组(n=49)和对照组(n=78),全部患者在10 min内完成首次心电图检测、床旁检测D-二聚体,其中研究组同时完成床旁心肺快速超声检查。比较两组进门-出门(DiDo)时间、首次心电图及D-二聚体检查时间、起病2 h内就诊比例、院内病死率等。结果研究组DiDo时间、首次心电图及D-二聚体检查时间均短于对照组,起病2 h内就诊比例高于对照组(P<0.01或0.05),而院内病死率差异无统计学意义(P>0.05)。研究组床旁超声扫查成功率为88.4%,对主动脉夹层、肺动脉栓塞、心包积液、胸腔积液、气胸均有较高的特异性、准确率(>90%)。结论应用床旁心肺快速超声联合D-二聚体检测可缩短高危非心脏源性胸痛患者的早期筛查、诊断时间,适合基层医疗卫生机构推广应用。更多还原

【Abstract】 Objective To evaluate the application of combined rapid bedside cardiopulmonary ultrasound(RBCPU)and D-dimer detection in chest pain treatment unit. Methods A total of 127 patients with acute chest pain were divided into study(n=49) and control(n=78) groups. All patients underwent first ECG and bedside D-dimer detection within 10 min, and RBCPU was added in study group. Door-in-door-out(DIDO) time, first ECG and D-dimer detection time, 2 h consultation rate after symptom onset, and in-hospital mortality were compared between two groups. Results Compared with control group, DIDO, first ECG and D-dimer detection time were lower, and 2 h consultation rate was higher(P<0.01 or 0.05) in study group. The in-hospital mortality was comparable between two groups(P>0.05). The success rate of RBCPU was88.4% in study group, with specificity and accuracy of >90% for aortic dissection, pulmonary embolism, pericardial effusion, pleural effusion, and pneumothorax. Conclusion Combined use of RBCPU and D-dimer detection can shorten the early screening and diagnosis time of high-risk patients with non-cardiac chest pain, which is suitable for community medical institutions.更多还原