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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。
Objective To investigate the clinical diagnosis and treatment of painless myocardial infarction. Methods The clinical data of 200 cases of myocardial infarction treated in our hospital from December 2009 to December 2011 were analyzed retrospectively. According to their clinical manifestations and specific diagnostic criteria, angina pectoris was divided into analgesic group (n = 122) And painless group (78 cases). The diagnosis, the complication and the treatment of the two groups were observed and compared. Results The rate of misdiagnosis in painless group was 17.95%. The misdiagnosis rate in painful group was 4.92%. The rate of misdiagnosis in painless group was significantly higher than that in painful group (P <0.01). In painless group, 62 cases were cured and 16 died. (P0.01) .The incidence of complications such as arrhythmia, heart failure, hypertension and diabetes in painless group was significantly higher than that in control group (P0.01) . Conclusions The clinical diagnosis of patients with painless myocardial infarction is more difficult and the misdiagnosis rate is higher. In order to avoid unnecessary losses to patients, the electrocardiogram and myocardial enzymes should be monitored in the clinical work to improve the diagnosis and treatment rate.