床旁心肺快速超声联合D-二聚体检测在胸痛救治单元中的应用  

Application of combined rapid bedside cardiopulmonary ultrasound and D-dimer detection in chest pain treatment unit

作　　者：谭晓晖 林嘉诚 陈华达 肖文鑫 朱可云 TAN Xiao-hui;LIN Jia-cheng;CHEN Hua-da;XIAO Wen-xin;ZHU Ke-yun(Department of Cardiovasology,Xinhui People’s Hospital,Affiliated Xinhui Hospital of Southern Medical University,Jiangmen 529100,China;Department of Emergency,Xinhui People’s Hospital,Affiliated Xinhui Hospital of Southern Medical University,Jiangmen 529100,China;Gujing Hospital,Xinhui People’s Hospital,Affiliated Xinhui Hospital of Southern Medical University,Jiangmen 529100,China)

机构地区：[1]江门市新会区人民医院,南方医科大学附属新会医院心血管内科,广东江门529100 [2]江门市新会区人民医院,南方医科大学附属新会医院急诊科,广东江门529100 [3]江门市新会区人民医院,南方医科大学附属新会医院古井分院,广东江门529100

出　　处：《广东医科大学学报》2021年第6期697-701,共5页Journal of Guangdong Medical University

基　　金：广东省医学科研基金指令性课题(No.C2020105);广东省公益研究与能力建设专项资金项目(No.2015A020210024)。

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。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.

关 键 词：胸痛救治单元 心肺超声 D-二聚体 

分 类 号：R540.4[医药卫生—心血管疾病]