POCUS在急诊高危胸痛患者快速诊断中的应用价值与进展

Applied Value and Progress of POCUS in the Rapid Diagnosis of High-Risk Chest Pain Patients in the Emergency Department

摘要: 急诊胸痛病因复杂且病情危重，快速鉴别高危胸痛(如急性冠脉综合征、主动脉夹层、肺栓塞、张力性气胸等)对改善患者预后至关重要。传统诊断方法依赖病史、心电图及实验室检查，常存在时间延迟或早期敏感性不足的局限。床旁即时超声(Point-of-Care Ultrasound, POCUS)作为一种无创、快速、可重复的影像学工具，在急诊环境中展现出独特优势。本文旨在系统阐述POCUS在高危胸痛病因快速筛查与鉴别诊断中的应用现状、具体操作流程、诊断效能、临床决策支持作用及其面临的挑战与未来发展方向，为优化急诊胸痛诊疗路径提供循证依据。

Abstract: The etiology of emergency chest pain is complex and the condition is often critical. Rapid differentiation of high-risk chest pain (such as acute coronary syndrome, aortic dissection, pulmonary embolism, tension pneumothorax, etc.) is crucial for improving patient prognosis. Traditional diagnostic methods rely on medical history, electrocardiography, and laboratory tests, which often suffer from time delays or insufficient early sensitivity. Point-of-Care Ultrasound (POCUS), as a non-invasive, rapid, and repeatable imaging tool, demonstrates unique advantages in the emergency setting. This article aims to systematically elaborate on the current application status, specific operational procedures, diagnostic efficacy, role in clinical decision support, as well as the challenges and future development directions of POCUS in the rapid screening and differential diagnosis of high-risk chest pain etiologies, providing an evidence-based basis for optimizing emergency chest pain diagnosis and treatment pathways.