主动脉夹层急性期院内死亡危险因素分析

目的：分析急性主动脉夹层（AD）住院死亡危险因素。方法：回顾性分析140例我院近10年AD住院患者的临床资料。结果：140例AD患者中A型AD63例（45％），B型AD77例（55％），平均年龄（53．2±11．8）岁，男女性别比3．4：1，急性期院内病死率29．3%，A型AD并发胸腔积液、心包积液、低血压（休克）、主动脉瓣返流是AD急性期住院死亡的主要原因，开展腔内隔绝术后B型AD病死率从25．9％下降到8％。结论：A型AD胸腔积液、急性心包积液、低血压（休克）、主动脉瓣返流是导致患者急性期院内死亡的4个独立危险因素，腔内隔绝术是治疗B型AD较为安全和有效的方法。

Risk Factor Analysis for Intrahospital Death of Acute Phase of Aortic Dissection

Objective：To analyze the risk factors for intrahospital death of acute aortic dissection （AD）. Methods： Clinical data of 140 patients with AD over last 10 years in our hospital were analyzed retrospectively. Results： Among 140 cases with AD, 63 （45%） were type A AD, and 77 （55%） were type BAD. The mean age was （53.2 ± 11.8）years old, the male/female ratio was 3.4：1. The intrahospital mortality was 29. 3 % in overall patients. Patients with type A AD complicated with pleural effusion, pericardial effusion, hypotension and aortic regurgitation were the main factors that causing death. The mortality of Type BAD decreased from 25.9% to 8% after endovascular stent-graft placement. Conclusion： As for Type A AD, pleural effusion, acute pericardial effusion, hypoten- sion, aortic regurgitation were the four independent risk factors of the intrahospital mortality of AD in acute phase. Patients with Type BAD could be effectively and safely treated by coated stent-graft endovascular placement.