李秀力 梅蕊

[摘要]目的 探討即时检测技术（POCT）在急诊胸痛患者危险程度评估中的诊断价值。方法 选取2016年10月～2018年10月北京核工业医院急诊科收治的180例急诊胸痛患者作为研究对象，根据其检测方法不同分为观察组（n=100）和对照组（n=80）。观察组采用POCT技术检测相关指标，对照组采用常规实验室方法检测相关指标。比较两组急诊滞留时间、标本检测时间、检测报告临床处置时间，并评估POCT检测准确性、抢救成功率、心血管事件发生率、复检准确率。结果 观察组急诊滞留时间、标本检测时间、检测报告临床处置时间、住院时间均短于对照组，差异有统计学意义（P<0.05）;两种方法诊断致命性胸痛的灵敏性、特异性、准确性相比，差异均无统计学意义（P>0.05）;观察组抢救成功率、复检准确率高于对照组，而心血管事件发生率低于对照组，差异均有统计学意义（P<0.05）。结论 POCT技术应用于急诊胸痛患者中，快捷可靠，可准确评估其危险程度，提高抢救成功率、复检准确率，减少心血管事件。

[关键词]即时检测技术;急诊;胸痛;危险程度;指导价值

[中图分类号] R446          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0058-04

Diagnostic value of point-of-care testing in risk assessment of patients with emergency chest pain

LI Xiu-li   MEI Rui

Department of Emergency， Beijing Nuclear Industry Hospital， Beijing   102413， China

[Abstract] Objective To evaluate the diagnostic value of point-of-care testing（POCT） in the risk assessment of patients with emergency chest pain. Methods From October 2016 to October 2018， 180 patients with emergency chest pain treated in emergency department of Beijing Nuclear Industry Hospital were selected as the research objects. They were divided into observation group （n=100） and control group （n=80） according to its detection method. The observation group used POCT technology to detect the relevant indicators， and the control group used the conventional laboratory method to detect. The emergency detention time， specimen detection time and clinical treatment time of detection reports were compared between the two groups. The emergency retention time， specimen detection time， detection report clinical disposal time of the two groups were compared， and the accuracy of POCT detection， the success rate of rescue， the incidence of cardiovascular events， and the accuracy of reexamination were compared between two groups. Results The emergency retention time， specimen detection time， clinical treatment time and hospitalization time of the observation group were all shorter than those of the control group， the differences were statistically significant（P<0.05）. The sensitivity， specificity and accuracy of the two methods were not statistically significant， the differences were not statistically significant （P>0.05）. The success rate of rescue and the accuracy of reexamination in the observation group were higher than those in the control group， while the incidence of cardiovascular events was lower than that in the control group， and the differences were statistically significant （P<0.05）. Conclusion The application of POCT in patients with emergency chest pain is fast and reliable. It can accurately assess the dangerous level， improve the success rate of rescue and the accuracy of retest， reduce cardiovascular events.

[Key words] Point-of-care testing; Emergency; Chest pain; Dangerous level; Guidance value

当今世界，多数国家的急诊科均面临患者过多、就诊等待时间过长、治疗延迟、危急重症患者无法及时给予足够的关注等问题，因此急诊医学关注的焦点是以最快的速度，最有效的手段，尽最大可能挽救患者的生命和最大限度地减轻患者伤残[1]。高危急性胸痛患者就医等待时间长，患者家属送血到化验室及取回检验报告都需要花费宝贵的时间，这将延长危重患者滞留在急诊室的时间，影响下一步的治疗处置，不仅增加危急重症或者的死亡率，同时增加患者及家属的负面情绪，导致医患矛盾[2]。即时检测技术……