主动脉夹层动脉瘤患者不同Stanford分型的临床特征分析及意义

目的分析主动脉夹层动脉瘤患者不同Stanford分型的相关临床特征，探讨其影响预后的危险因素及其意义。方法收集主动脉夹层动脉瘤患者病例79例，按Stanford分型分为A型组26例和B型组53例，回顾性分析两组患者的临床资料，观察病情变化及预后。结果StanfordA型患者的胸痛、背痛、胸闷气促和意识障碍的发生率高于StanfordB型患者，差异均有统计学意义（P均〈0．05）；而腹痛、腰痛和无症状的发生率StanfordB型患者要高于StanfordA型患者，差异均有统计学意义（P均〈0．05）。StanfordA型患者的就诊时间、平均年龄、入院时血压和既往有高血压史的病例均少于StanfordB型患者，而既往有马凡综合征病史的病例StanfordA型高于StanfordB型，差异均有统计学意义（P均〈0．05）。StanfordA型患者的心包积液和意识障碍的发生率及死亡率均高于StanfordB型患者（P〈0．05）。结论主动脉夹层动脉瘤StanfordA型患者的发病年龄相对较轻，病情凶险，并发心包积液，心力衰竭和意识障碍的发生率和死亡率高。明确诊断为StanfordA型主动脉动夹层动脉瘤或是StanfordB型患者出现心包积液、胸腔积液等并发症是提示患者死亡的危险指标。

Analysis on clinical features of patients with aortic dissection in different Stanford types

Objective To analyze the clinical features of patients with aortic dissection in different Stanford types,and explore the risk factors and prognostic significance.Methods Seventy-nine patients with aortic dissection were divided into type A group (26 cases) and type B group (53 cases) according to different Stanford types.The clinical data of the two groups were retrospective analyzed,and the condition changes and prognosis were observed.Results The incidence of chest pain,back pain,chest distress,breathles...