主动脉夹层致死的临床病理分析

目的分析主动脉夹层的临床及病理特点。方法回顾性分析1998年1月-2011年10月26例主动脉夹层致死的临床及法医尸检病理资料,对其发病、死亡经过、诊断、死因进行总结。结果 26例主动脉夹层平均发病年龄为39.2岁,男女比例为3.3︰1;26例中6例无临床诊断,17例误诊,3例疑似诊断。26例主动脉夹层中,夹层破裂致心包填塞死亡20例,夹层破裂致失血性休克死亡5例,主动脉夹层未破裂1例系心衰致死;26例按DeBakey分类标准9例为Ⅰ型,14例为Ⅱ型,3例为Ⅲ型。结论临床应警惕主动脉夹层的特殊临床表现并采取必要的辅助检查,有助于主动脉夹层的诊治和减少医疗纠纷的发生。

Clinical Pathological Analysis of Death from Aortic Dissection

Objective To analyze the clinical and pathologic features of aortic dissection.Methods Twenty-six autopsied cases of aortic dissection from January 1998 to October 2011 were retrospectively analyzed,and the analysis included the onset of the disease,death process,diagnosis and cause of death.Results The average age of 26 arotic dissection patients was 39.2 years old.The ratio of men to women was 3.3 to 1.Among the 26 patients,6 had no diagnosis,17 were misdiagnosed and 3 had suspected diagnosis.There were 25 cases of ruptured aortic dissection,among whom 20 died from cardiac tamponade and 5 died from hemorrhage shock.The other one patient with non-broken dissection died from heart failure.Conclusion The special clinical manifestations of aortic dissection should be paid special attention and necessary auxiliary examinations should be taken,which can promote the diagnosis and treatment of aortic dissection and reduce the occurrence of medical disputes.