CAJ | 학술논문

目的：研究院外急救胸痛患者病种病因、治疗、预后。方法调查分析乌鲁木齐市院外急救2009年1月1日~2012年12月31日因胸痛症状就诊的患者的病因组成比例，急诊处理方案、2周、1个月随访。随访采用门诊随访、住院随访、电话随访的方式。8位的研究者记录研究内容包括：患者的病史（症状、发病时间，到达医院急诊时间，胸痛特点）、体格检查、实验室检查，以及心电图、诊断和治疗方案、用药情况及治疗时间、并进行院内跟踪随访情况。结果院外急救胸痛患者约占到内科就诊人数的5%，病因排名前三位的是冠心病、肺栓塞、主动脉夹层。根据院外急救患者在院内确诊的急性冠脉综合征患者中，胸痛发作2 h就诊患者为14.19%，胸痛发作6 h就诊患者为43.23%，胸痛发作8 h就诊患者为23.45%，患者求治时间延迟明显。急诊胸痛收住院比例3380例（21.14%）。结论胸痛相关的致死性疾病中，由于冠心病发病率高（72.57%）、成为胸痛患者需要鉴别诊断的主要疾病；急诊转运中耽搁的时间较长，早期治疗不及时，需要向全社会患者加强普及相关的胸痛健康知识，提高急诊患者就医的依从性，从而改善预后。
목적：연구원외급구흉통환자병충병인、치료、예후。방법조사분석오로목제시원외급구2009년1월1일~2012년12월31일인흉통증상취진적환자적병인조성비례，급진처리방안、2주、1개월수방。수방채용문진수방、주원수방、전화수방적방식。8위적연구자기록연구내용포괄：환자적병사（증상、발병시간，도체의원급진시간，흉통특점）、체격검사、실험실검사，이급심전도、진단화치료방안、용약정황급치료시간、병진행원내근종수방정황。결과원외급구흉통환자약점도내과취진인수적5%，병인배명전삼위적시관심병、폐전새、주동맥협층。근거원외급구환자재원내학진적급성관맥종합정환자중，흉통발작2 h취진환자위14.19%，흉통발작6 h취진환자위43.23%，흉통발작8 h취진환자위23.45%，환자구치시간연지명현。급진흉통수주원비례3380례（21.14%）。결론흉통상관적치사성질병중，유우관심병발병솔고（72.57%）、성위흉통환자수요감별진단적주요질병；급진전운중탐각적시간교장，조기치료불급시，수요향전사회환자가강보급상관적흉통건강지식，제고급진환자취의적의종성，종이개선예후。
Objective To explore emergency chest pain on etiology, treatment and prognosis. Methods An investigation was performed on all the chest pain cases collected in between Jan. 2009 and Dec. 2012 for their types of cause proportion, treatments provided on pre-hospital stage, as well as follow-up visits with the patients. The visit included patient's medical history, symptoms, onset time, arriving time at emergency room, description of the chest pain, physical examination, laboratory examination, and electrocardiogram (ECG), diagnosis and treatment, medication and treatment time, and 2-week and one-month follow-up visits. Results It reflected 5%of chest pain on pre-hospital stage, caused in descent order: coronary heart disease, pulmonary embolism, and aortic dissection. Pre-hospital emergency record indicated 14.19% of the patients seeking medical service in two hours, 43.23% in six hours, 23.45% in eight hours, which appeared a delay. 21.14% of pre-hospital chest pain cases ended up as hospitalization. Conclusion Coronary heart disease, as one of major diseases which caused chest pain, demands early and timely treatment. To prevent it from happening and reduce mortality of the disease, it is important to popularize chest pain related knowledge.