胃食管反流病12例误诊心绞痛临床分析

目的总结胃食管反流病误诊为心绞痛的原因及鉴别诊断要点。方法回顾性分析2015年2月-2019年6月在我院被误诊为心绞痛的胃食管反流病12例的临床资料。结果本组均以发作性胸痛为首发症状,经心电图、超声心动图等检查首诊为心绞痛,予相关治疗无效后,行胃镜检查确诊为胃食管反流病。首次就诊至确诊时间5~40 d。12例确诊后予兰索拉唑肠溶片+伊托必利分散片+铝镁二甲硅油咀嚼片治疗8周,治愈8例,显效及有效各2例。结论部分胃食管反流病与心绞痛临床症状相似,极易误诊。临床医师需掌握二者临床特点,开拓诊断思维,熟悉鉴别诊断要点,以提高诊断准确率。

Clinical Analysis of 12 Cases of Gastroesophageal Reflux Disease Misdiagnosed as Angina Pectoris

Objective To summarize the causes of misdiagnosis of gastroesophageal reflux disease(GERD) as angina pectoris and the key points of differential diagnosis. Methods The clinical data of 12 cases of GERD misdiagnosed as angina pectoris in our hospital from February 2015 to June 2019 was retrospective analyzed. Results All patients developed paroxysmal chest pain as the initial symptom. According to the results of ECG and echocardiography, the initial diagnosis was angina pectoris;however, relevant treatment was ineffective. Finally, they were all diagnosed as GERD by gastroscopy. The duration from the first visit to the final diagnosis was 5-40 d. Twelve cases were treated with Lansoprazole enteric coated tablets+Itopride dispersible tablets+aluminum-magnesium-dimethylsilicone chewable tablets for 8 weeks. Eight cases were cured, and the treatment was markedly effective in 2 cases and effective in 2 cases. Conclusion Given similar clinical symptoms of certain GERD and angina pectoris, GERD is more likely to be misdiagnosed. Clinicians need to master the clinical characteristics, develop diagnostic thinking, and be familiar with the key points of differential diagnosis to improve the accuracy of diagnosis.