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目的探索特殊表现的急性心肌梗死的诊断。方法回顾分析福清市高山镇中心卫生院2001-02-2009-02收治的急性心肌梗死初诊误诊23例的临床资料。结果被误诊为消化系统疾病7例(急性胃肠炎3例,急性胆囊炎2例,急性胃穿孔、急性胰腺炎各1例),误诊为脑血管神经精神系疾病6例(缺血性脑卒中5例,梅尼埃病1例),误诊为肺部疾病3例(慢性支气管炎并感染1例、支气管哮喘2例),另有7例特殊部位疼痛为首发,分别被误诊为牙痛2例、咽炎2例、食管癌及腰椎病各1例、肩周炎1例。结论特殊表现的急性心肌梗死的诊断,应全面综合分析病史,要及时和动态的检测心电图、心肌酶、肌钙蛋白。
Objective To explore the special diagnosis of acute myocardial infarction. Methods The clinical data of 23 cases of newly diagnosed acute myocardial infarction (MI) misdiagnosed in 2001 to 2009-2009 in Gaoshan Township Central Hospital of Fuqing City were retrospectively analyzed. The results were misdiagnosed as digestive diseases 7 cases (3 cases of acute gastroenteritis, acute cholecystitis in 2 cases, acute gastric perforation, acute pancreatitis in 1 case), misdiagnosed as cerebrovascular neuropsychiatric diseases in 6 cases (ischemic brain 5 cases of stroke, 1 case of Meniere’s disease), misdiagnosed as pulmonary disease in 3 cases (chronic bronchitis and infection in 1 case, bronchial asthma in 2 cases), and another 7 cases of special parts of the pain as the first episode were misdiagnosed as toothache 2 Cases, pharyngitis in 2 cases, esophageal cancer and lumbar spondylosis in 1 case, 1 case of frozen shoulder. Conclusion Special diagnosis of acute myocardial infarction should be comprehensive and comprehensive analysis of medical history, to timely and dynamic detection of ECG, myocardial enzymes, troponin.