老年危重症患者并发急性心肌梗死漏诊原由探讨.pdfVIP

, . 1997, . 16, . 6 356 Ch in J Geriatr D ec V o l N o 老年危重症患者并发急性心肌梗死 漏诊原因探讨 王瑞萍　钱贻简　陈曼丽 　　摘要　目的　探索老年人急性心肌梗死 ( ) 易漏诊的原因, 以提高对老年人心肌梗死的正确诊 AM I 断率。　　方法　总结20年中尸检有AM I 老年患者的临床与病理资料。　　结果　46例AM I 中11例 (23 9% ) 发生在危重疾病的终末期, 其中9例漏诊, 占46例的196% , 占11例的818% 。11例临床上均 患冠心病及其它疾病, 尸检均有冠状动脉粥样硬化病变1～ 3支, 管腔狭窄～ 级。心肌梗死部位: 左 室前壁或前侧壁6例, 心内膜下2例, 左室乳头肌、室间隔、心尖部和右室各1例。4例心脏破裂。　　结论 　 的症状易被肿瘤晚期症状和脑血管病的意识障碍等所掩盖, 临床上应尽可能多次检查心电图及 AM I 心肌酶谱, 以降低AM I 漏诊率。 　　关键词　心肌梗死诊断　　脑血管意外并发症 The causes for m isdiagnosis of acute m yocardial infarction in aged patien ts with other cr itical diseases W ang R u ip ing , Q ian Y ij ian, Chen M anli. B eij ing H osp ital , B eij ing 100730 　　Abstract　Objective　To find the causes of m isdiagno sis of acute m ycardial infarction (AM I) in , . 　　 aged patients w ith o ther critical diseases so as to increase the rate of accurate diagno sis M ethods 　 46 20 . 　　 T he data of aged AM I cases w ith autop sy perfo rm ed in a period of years w ere analysed 　 (23 9% ) 46 . Results E leven of the cases w ere found to have critical diseases o ther than AM I T he di agno sis of AM I w as m issed in