急诊非ST抬高急性冠脉综合征患者的分层诊断

目的探讨非ST抬高急性冠脉综合征（ACS）患者的急诊分层诊断的可行性,提高急诊医师对非sT抬高ACS的诊断水平。方法前瞻观察性研究,胸痛及胸痛等同症状急诊就诊的患者。急诊医师通过临床分层诊断将患者分为ACS组和非ACS组,随访确诊的结果或30d后的临床转归情况。所有数据经SPSSl7．0统计软件进行统计学处理。结果入选200例,有效188例,其中ACS组106例,确诊ACS94例,非ACS组82例,随访30天,确诊ACS2例,无死亡病例。急诊分层诊断流程及标准对非ST抬高ACS诊断的敏感性为97．9％,特异性为87．O％。结论急诊医生经过培训,通过对非sT抬高ACS患者的分层诊断,可初步实现非SF抬高ACS的早期诊断及规范化治疗,改善患者预后,降低漏诊率,避免过度医疗。

Hierarchical diagnosis of non-ST-elevation acute coronary syndrome in emergency room

Objective To explore the feasibility of hierarchical diagnosis on non-ST-elevation acute coronary syndrome （NSTEACS） and improve aecuracy of the diagnosis in practice in emergency room （ER）. Methods In such a prospective and observational research, the patients with chest pain or equivalent syndrome are divided into acute coronary syndrome （ACS） group and non-ACS group, and their respective diagnosis result and the 30-day＇ s follow-up were analyzed with SPSS17.0 software. Results In a total of 188 participated patients, the two groups were identified as ACS group of 106 of which 94 of them were identified as ACS, and non-ACS group of 82 of whieh 2 were found as ACS in the 30-day＇ s follow-up. No death case was found. As a result, hierarchical diagnosis carries out a 97.7% accuracy with a differentiate rate of 87.0%. Conclusion Hierarchical diagnosis is considered being effective in diagnosing accuracy and standardizing and providing the proper treatment to those who suffered from NSTE-ACS in emergency room.