多联指标分析法对急诊急性主动脉夹层诊断价值.docVIP

多联指标分析法对急诊急性主动脉夹层诊断价值 　　【摘要】 目的 探讨多联指标分析法对急诊急性主动脉夹层识别和诊断价值。方法 回顾性分析32例急性主动脉夹层患者的多项临床资料， 分析多联指标分析法诊断急性主动脉夹层的可靠性。结果 符合指标1（胸痛、腹痛和背痛， 伴坐卧不安躁动感）的患者有28例， 符合指标2（休克样表现）为26例， 符合指标3（双侧血压差）为21例， 符合指标4（神经体征）为8例， 符合指标5（D-二聚体升高）为29例， 符合指标6（胸片纵隔增宽）为18例。32例患者多指标分析得分与确诊例数中3分的患者占最大比例， 4分其次。得分为3分患者中， 指标1+指标2+指标5的组合确诊率最高， 指标1+指标3+指标5次之。结论 运用多联指标分析法能对急诊急性主动脉夹层进行快速高效的诊断， 可靠性高， 为对后续诊治和降低医疗风险有重要意义， 对一线医师尤其是基层医师具有极高的临床意义。 　　【关键词】 急性主动脉夹层；多联指标分析法；诊断 　　【Abstract】 Objective To explore the identification of mult-index analysis for acute aortic dissection and its diagnostic value. Methods Clinical data of 32 acute aortic dissection patients were retrospectively analyzed， and analysis was made on reliability of mult-index analysis for acute aortic dissection. Results 28 patients were in accord with index 1 （chest pain， abdominal pain and back pain， complicated with restless feeling）， 26 patients in accord with index 2 （shock）， 21 cases in accord with index 3 （blood pressure difference on both sides）， 8 patients in accord with index 4 （neurologic signs）， 29 patients in accord with index 5 （rising D-dimer）， and 18 patients in accord with index 6 （widened chest radiograph mediastinum）. 3 points patients of multi-index analysis score and diagnosed cases accounted for the largest proportion in 32 patients， followed by 4 points. In 3 points patients， combination of index 1 + index 2 + index 5 had the highest diagnostic rate， followed by index 1 + index 3 + index 5. Conclusion Application of multi-index analysis can make quick and efficient diagnosis for the emergency treatment of acute aortic dissection with high reliability， which provides important significantce for follow-up treatment and decline of medical risk， and it also have high clinical significance for first-tier physicians， especially basic level physicians. 　　【Key words】 Acute aortic dissection； Mult-index analysis； Diagnosis 　　急性主?勇黾胁悖?AAD）是心血管疾病中危重症之一， 近年发病率有增加趋势。急性主动脉夹层是一种极为凶险的大动脉疾病， 死亡率高[1]。急性主动脉夹层表现形式多样， 典型表现为突发撕裂样胸背痛， 此外还能常有腹痛、