院外急救医师应用床旁诊断技术对高危胸痛患者的诊断价值探讨  

The value of bedside diagnostic technique applied by out of hospital emergency physicians in the diagnosis of high-risk patients with chest pain

作　　者：周卜邻[1] 王逸君[1] 蒋辰芳[2] 蔡友香 ZHOU Bulin;WANG Yijun;JIANG Chenfang;CAI Youxiang(First People's Hospital of Chenzhou,Chenzhou Hunan 423000,China)

机构地区：[1]郴州市第一人民医院中心医院院外急救科,湖南郴州423000 [2]郴州市第一人民医院中心医院烧伤科,湖南郴州423000

出　　处：《中国急救复苏与灾害医学杂志》2022年第4期453-455,464,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：湖南省卫生健康委科研计划项目资助(编号:20201105);湖南省湘南学院立项课题(编号:2020XJ101)。

摘　　要：目的对院外急救医师进行相关床旁诊断技术的培训,以期在院外急救中寻找一种简单、易行、可快速明确高危胸痛的诊断方法并对该法进行探讨。方法本研究回顾性分析2020年1月—2021年1月郴州市第一人民医院中心医院急诊科与院外急救科处理的163例高危胸痛患者的临床资料,其中男性83例,女性80例,年龄19~73岁,将急诊科处理的高危胸痛患者为对照组(n=84),院外急救科医师处理的高危胸痛患者为试验组(n=79),比较两组高危胸痛患者诊断时间、诊断成功率、急诊科抢救室停留时间、完成高危胸痛患者诊断所需费用。结果与对照组相比,试验组在性别及高危胸痛病因对比差异均无统计学意义(P>0.05),试验组诊断时间、急诊科抢救室停留时间、确诊费用显著下降(P<0.05),试验组诊断成功率与对照组差异无统计学意义(P>0.05)。结论针对院外急救医师进行程序化床旁诊断技术的培训,可以提高其对高危胸痛患者的诊断能力,减少急诊滞留时间及花费,有利于避免医患矛盾。Objective To train out of hospital emergency physicians in bedside diagnostic techniques,in order to find a simple,easy and rapid diagnostic method for high-risk chest pain in out of hospital emergency,and to explore this method.Methods The clinical data of 163 patients with high-risk chest pain treated by the emergency department and the out of hospital emergency department of our hospital from January 2020 to January 2021 were retrospectively analyzed,including 83 males and 80 females,aged 19~73 years.The patients with high-risk chest pain treated by the emergency department were used as the control group(n=84),and the patients with high-risk chest pain treated by the out of hospital emergency department were used as the experimental group(n=79),The diagnostic time,diagnostic success rate,residence time in the emergency room and the cost of completing the diagnosis of high-risk chest pain patients were compared between the two groups.Results Compared with the control group,there was no significant difference in gender and etiology of high-risk chest pain in the experimental group(P>0.05).The diagnostic time,stay time in emergency room and diagnostic cost in the experimental group decreased significantly(P<0.05).There was no significant difference in diagnostic success rate between the experimental group and the control group(P>0.05).Conclusion The training of programmed bedside diagnostic technology for out of hospital emergency doctors can improve their diagnostic ability for patients with high-risk chest pain,reduce the emergency detention time and cost,and avoid the contradiction between doctors and patients.

关 键 词：院外急救医师 床旁超声 心电图 高危胸痛 

分 类 号：R605.97[医药卫生—急诊医学]