心源性胸痛的特征性改变对快速分诊的指导意义  

The directive characteristics of cardiogenic chest pain in rapid triage patients

作　　者：张晓雪[1] 郑媛婕 刘君[1] 靳文[1] 黄琨[1] 梁少兰[1] 陈佳[1] 杜作义[1] 

机构地区：[1] 广东省第二人民医院心血管内二科,广东省广州市510317 [2] 广州医科大学第一附属医院胸外科

出　　处：《中国心血管病研究》2016年第6期537-539,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨心源性胸痛的特征性改变对快速分诊的指导意义.方法 回顾性研究我院心内科门急诊2013年6月至2014年6月以胸痛为主诉首诊的患者共386人次,其中因外伤所致的、不能确诊的、住院资料或随访资料不全的胸痛患者共67例予以剔除,剩余319例纳入本研究.根据出院诊断,将确诊为心源性胸痛（CCP）患者分入CCP组,其余非心源性胸痛（NCCP）患者分入NCCP组.比较指标包括：可视化数字疼痛评分、劳力性胸痛、疼痛范围、放射痛、反复发作性胸痛、胸痛持续时间、低血压、心电活动是否稳定、血氧饱和度、诊疗时间等.结果 与NCCP组相比,劳力性胸痛（70∶115,x2=8.70）、反复胸痛发作（54∶87,x2=5.01）、低血压（28∶25,x2=12.71）、心电活动不稳定（24∶20,x2=11.81）是CCP患者的高危因素,也更常见于CCP组,且确诊时间更短（85.4∶131.6,t=2.34）,差异有统计学意义.结论 劳力性胸痛、反复胸痛发作、低血压及心电活动不稳定对快速分诊CCP患者有重要指导意义.Objective To investigate the significance of characteristics of rapid triage of cardiogenic chest pain patients. Methods From 2013 June to 2014 June, the data of all 386 patients with chief complain of chest pain were retrospectively analyzed. In which, 67 patients were excluded because of indefinite diagnosis or incom- plete data, and the rest 319 patients were enrolled and divided into two groups： Group CCP was defined as final diagnosis of cardiogenic chest pain （CCP）, while Group NCCP as non-CCP （NCCP）. The following indexes were analyzed between groups including numerical rating scale （ NRS ）, exertional chest pain （ ECP ）, pain size （ PS ）, ra- diating pain （ Rad-P ）, repeating pain onset （ RPO ）, rest pain （ Rest-P ）, low blood pressure （LBP）, unstable elec- trocardio-activity（UEA）, SpO2, and time of diagnosis（TOD） as well. Results As for logistic regression analysis, ECP, RPO, LBP and UEA are risk factor for patients with CCP. Compare Group CCP with Group NCCP, ECP （70：115, x2=8.70）, RPO （54：87,）（2=5.01 ）, LBP （28：25, X2=12.71 ） and UEA （24：20, A2=11.81 ）, as well as short TOD （85.4：131.6, t=2.34）, were more often occurred in Group CCP. Conclusion It was directive signifi- cance for rapid triage of CCP patients using the characteristics of chest pain including ECP, RPO, LBP and UEA.

关 键 词：心源性胸痛 快速分诊 诊断 治疗 

分 类 号：R54[医药卫生—心血管疾病]