44例主动脉夹层临床分析

目的 探讨主动脉夹层患者的患病危险因素、临床特征、诊治方法及预后.方法 对我院2005-2008年诊治的44例主动脉夹层患者临床资料进行回顾性分析.结果 主动脉夹层发生的常见病因是高血压.首发表现以胸痛为常见(部分病例以并发症为首发).CT和MRI检查对主动脉夹层的确诊率较超声检查高,但由于超声检查价格便宜,床旁操作方便,故有疑诊患者,可做常规超声检查.主动脉夹层的治疗有内科保守治疗,外科手术治疗和血管内带膜支架治疗.结论 高血压是主动脉夹层的主要危险因素,其临床表现复杂多变,误诊率高.内科治疗时血压控制多需多种降压药物联合应用,然而根据临床分型和病情采取外科手术、介入治疗可降低病死率和改善患者的预后.

Clinical analysis of 44 patients with aortic dissection

Objective To investigate the risk factors, clinical characteristics, treatment and prognosis of aortic dissection. Methods Forty-four patients with aortic dissection were analyzed from 2005 to 2008 in our hospital retrospectively. Results Hypertension was a common cause of aortic dissection. Aortic dissection showed diverse clinical manifestations. Chest pain was a common initial symptom, whereas some patients' initial symptoms were atypical(e. g. complications). CT and MRI examination could diagnose aortic dissection at a high accurate rate compared with echocardiography. However,ultrasound examination was cheap and convenient,thus could be used as routine examination when someone has suspected diagnosis. As to the treatment of aortic dissection, there were medical conservative, surgical and endovascular stent treatment Conclusions Hypertension is a major risk factor of aorticdissection. Aortic dissection showed diverse clinical manifestations, thus misdiagnosis may occur frequently. Medical treatment should combine a variety of antihypertensive drugs. Surgery or interventional therapy according to the clinical type and condition can reduce the fatality and improve the prognosis of patients.