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Stroke：头颈动脉夹层在急诊误诊的情况分析

2020-04-18 MedSci原创 MedSci原创

误诊急诊头颈动脉夹层
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30例夹层患者中约有1例患者在诊断前2周内被误诊。

头颈动脉夹层是引起脑卒中的重要原因之一。夹层的临床表现可能类似于良性神经系统疾病，会出现误诊或漏诊。

近日，心血管疾病领域权威杂志Stroke上发表了一篇研究文章，研究人员使用了2005年至2015年佛罗里达和2006年至2015年纽约的所有非联邦医院急诊部就诊和入院的行政索赔数据进行了一项回顾性队列研究，并使用经验证的第九版国际疾病分类CM代码确定了因颈头动脉夹层而住院的成年患者。研究人员将可能的夹层误诊定义为在诊断前的14天内，因夹层的症状或体征(包括头痛、颈部疼痛和局灶性神经功能缺损)进行急诊治疗并出院。研究人员采用多变量Logistic回归比较有和无可能误诊患者的不良临床结局。

在7090例诊断为夹层的患者中(平均年龄为52.7岁，女性占44.9%)，218例(3.1%[95%CI为2.7%-3.5%])患者曾有过可能的急诊误诊。在对人口统计资料和血管危险因素进行调整后，在有或无可能误诊的夹层患者中，卒中发生率(比值比为0.82[95%CI为0.62-1.09])和住院死亡率(比值比为0.26[95%CI为0.07-1.08])无显著差异。

由此可见，30例夹层患者中约有1例患者在诊断前2周内被误诊。

原始出处：

Ava L. Liberman.Misdiagnosis of Cervicocephalic Artery Dissection in the Emergency Department.stroke.2020.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.029390

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    2020-09-06 xiaoyeshuang

    #颈动脉夹层#

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    2020-10-29 stfoxst

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    2020-04-19 mhzhuang@stu.e

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    2020-12-28 mhzhuang@stu.e

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