刘武鹏 梁金峰 魏婧

[摘要] 目的 研究急性食管源性胸痛誤诊为冠心病的诱因以提供对症治疗方法。 方法 数据采集本院2019年1月至2020年8月收治的30例急性食管源性胸痛患者，入院后均行动态心电图、DR胸片、心脏超声心动图及胃镜检查，分析误诊为冠心病原因机制，提供雷尼替丁、西沙比利及黏膜保护剂等用药治疗措施、尽早稳定病情、控制疾病进展，综合分析用药后生活质量、自我护理能力及疗效。 结果 与治疗前比较，治疗后患者躯体领域、社会功能、生命活力及物质生活评分更高，差异有统计学意义（P<0.05）;与治疗前比较，治疗后患者自我责任感、自我概念、健康知识及自我护理技能评分更高，差异有统计学意义（P<0.05）;患者治疗有效率为96.67%，效果显著。结论 因胸痛入院患者在急诊科就诊时，优先考虑冠心病，将肺部病变、神经痛及心源性胸痛等疾病排除后，也需警惕急性食管源性胸痛发生，待疾病确诊后提供对症用药治疗，达到控制疾病目的，可在临床推广应用。

[关键词] 食管源性胸痛;冠心病;心绞痛;生活质量;自我护理能力;治疗效果;不良反应

[中图分类号] R571          [文献标识码] B          [文章编号] 1673-9701（2021）35-0105-04

Analysis of acute esophageal chest pain misdiagnosed as coronary heart disease

LIU Wupeng1   LIANG Jinfeng1   WEI Jing2

1.Department of Cardiology，Affiliated Baiyun Hospital of Guizhou Medical University， Guiyang   550014，China; 2.Department of Endocrinology， Affiliated Baiyun Hospital of Guizhou Medical University，Guiyang   550014，China

[Abstract] Objective To study the cause of misdiagnosis of acute esophageal chest pain as coronary heart disease and provide symptomatic treatment. Methods Data of 30 patients with acute esophageal chest pain admitted to our hospital from January 2019 to August 2020 were collected. Holter electrocardiogram， DR chest radiograph， echocardiography and gastroscopy were performed after admission， and the cause and mechanism of misdiagnosis as coronary heart disease were analyzed. Medication treatments including ranitidine，cisapride and mucosal protective agents were given to stabilize condition as soon as possible and control disease progression. The quality of life，self-care ability and efficacy after treatment were comprehensively analyzed. Results The scores of physical domain， social function， vitality， and material life after treatment were higher than those before treatment，with statistically significant differences（P<0.05）. The sense of self-responsibility，self-concept，health knowledge and self-care skills score after treatment were higher than those before treatment，with statistically significant differences （P<0.05）. The treatment effective rate was 96.67%，which was significant. Conclusion When patients admitted to hospital with chest pain go to the emergency department，coronary heart disease should be considered at first. After excluding pulmonary disease， neuralgia， and cardiogenic chest pain， it is also necessary to pay attention to the occurrence of acute esophageal chest pain and provide symptomatic treatment after diagnosis to control the disease. It can be promoted and applied in clinical practice.

[Key words] Esophageal chest pain; Coronary heart disease; Angina pectoris; Quality of life; Self-care ability; Treatment efficacy; Adverse events

临床常见病、多发病是急性食管源性胸痛，是指食管功能障碍、食管疾病引起患者有胸痛表现，具有烧灼样、挤压性疼痛等特点，其中胸骨下发作疼痛、烧心为较典型症状，多在饭后1 h内发病，与心绞痛相似，分析病因较复杂[1]，可能与情绪过度紧张、食用刺激性较强食物或过度锻炼……