无痛性心肌梗死的临床诊断与治疗分析

目的探讨无痛性心肌梗死的临床诊断与治疗。方法对2009年12月至2011年12月在我院治疗的200例心肌梗死患者的就诊过程进行回顾性分析,根据患者的临床表现及具体的诊断标准将心绞痛分为有痛组(122例)和无痛组(78例),观察比较两组患者的诊断情况、相关并发症以及治疗情况。结果无痛组误诊率17.95%;有痛组误诊率4.92%,无痛组误诊率显著高于有痛组(P<0.01);无痛组治愈62例,死亡16例;有痛组治愈113例,死亡9例,无痛组治愈率明显低于对照组(P<0.01);无痛组心律失常、心衰、高血压、糖尿病等并发症发生率显著高于对照组(P<0.01)。结论无痛性心肌梗死患者的临床诊断较困难,误诊率较高,为了避免给患者造成不必要的损失,临床工作中应加强对患者的心电图及心肌酶的监测,以提高诊断及治疗率。

Painless myocardial infarction of the clinical diagnosis and treatment analysis

Objective to explore the painless myocardial infarction clinical diagnosis and treatment. Methods In December 2009 to December 2011,in our hospital treatment of 200 cases of patients with myocar- dial infarction medical examination process were analyzed retrospectively, according to the patient＇s clinical manifestations and specific diagnosis standard will be divided into angina pectoris pain group （ n -- 122 ） and painless group （n = 78 ）, observation compared between the two groups of patients with diagnosis, related com- plications, and treatment. Results Painless group the misdiagnosis rate was 17.95%. Pain group the misdiag- nosis rate was 4. 92%, without the misdiagnosis rate was significantly higher than that of pain group, （ P 〈 0. 01 ） ; 62 cases were cured without group, 16 cases of death; 113 cases were cured pain group, 9 were dead, painless cure rate was significantly lower than the control group, （P 〈 0. 01 ） ;Painless group arrhythmia, heart failure, high blood pressure and diabetes complication rate was significantly higher than the control group, （ P 〈 0. 01 ）. Conclusion painless myocardial infarction patients for clinical diagnosis is difficult, the misdiagnosis rate is higher, in order to avoid unnecessary loss to patients, clinical work should be to strengthen the ecg pa- tients and the monitoring of myocardial enzymes, in order to improve the diagnosis and therapy.