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目的总结特殊心电图误诊为急性心肌梗死((acute myocardial infarction,AMI)的临床经验。方法对农七师医院2001～2007年所诊治心肌梗死患者292例中以特殊心电图误诊为AMI的10例患者,根据入选AMI诊断标准的误诊病例,分析临床表现、实验室检查、心电图表现。结果导致误诊的特殊心电图正确诊断为:心尖部肥厚型心肌病1例,肥厚梗阻型心肌病1例,B型预激综合征1例,蛛网膜下腔出血1例,急性肺栓塞1例,急性胰腺炎1例,左侧气胸1例,急性重症心肌炎2例,白塞氏病1例。结论临床医师对于特殊心电图的相关知识及急性心肌梗死的诊治进展、鉴别应加强学习,提高诊治水平,减少误诊率。
Objective To summarize the clinical experience of misdiagnosis of special electrocardiogram (ECG) as acute myocardial infarction (AMI) .Methods A total of 10 patients with AMI who were misdiagnosed as AMI by special electrocardiogram in 292 patients with MI diagnosed and treated in Nongqiu Teachers’ Hospital from 2001 to 2007, According to the misdiagnosed cases of AMI diagnostic criteria, clinical manifestations, laboratory tests, ECG findings.Results The diagnosis of misdiagnosed special electrocardiogram correctly diagnosed as: apical hypertrophic cardiomyopathy in 1 case, hypertrophic obstructive cardiomyopathy in 1 case, type B pre Irritable complex syndrome in 1 case, subarachnoid hemorrhage in 1 case, acute pulmonary embolism in 1 case, acute pancreatitis in 1 case, left pneumothorax in 1 case, acute severe myocarditis in 2 case and Behcet’s disease in 1 case.Conclusion The clinician’s special ECG related knowledge and diagnosis and treatment of acute myocardial infarction, identification should strengthen learning, improve diagnosis and treatment, reduce the misdiagnosis rate.