28例主动脉夹层急诊诊断治疗观察

目的探讨主动脉夹层(AD)的病因、临床特点、诊断方法,以提高临床急诊医师对该病的认识.方法回顾性分析2006年1月-2012年12月急诊诊治28例AD患者的临床情况.结果28例 AD 患者中有20例患有高血压,9例患有高血压合并冠心病,4例患有糖尿病,3例马凡氏综合征;28例AD患者以典型疼痛为首发症状20例,其余8例疼痛症状不明显;初步诊断为AD患者15例,死亡2例;延误诊断13例,死亡7例.结论 AD临床表现复杂多样,应加强对早期不典型症状的认识,通过全面细致的辅助检查及时做出正确诊断,及时治疗以降低病死率.

Acute aortic dissection diagnosis treatment and observation of 28 cases

Objective To investigate the etiology of aortic dissection（AD）, clinical characteristics, diagnosis method, in order to improve the clinical emergency awareness of the disease. Methods Retrospective analysis of the clinical situation in 2006 January-2012 year in December the emergency diagnosis and treatment of 28 cases of patients with AD. Results 28 cases of patients with AD in 20 patients with hypertension, 9 patients with hypertension and coronary heart disease, 4 cases with diabetes, 3 patients with Marfan syndrome; 28 cases of AD patients with typical pain as the first symptom of 20 cases, the remaining 8 cases with pain symptoms was not obvious; a preliminary diagnosis of 15 patients with AD, 2 cases of death; delay in diagnosis of 13 cases, 7 cases of death. Conclusion The clinical manifestation of AD was complicated, should strengthen the early atypical symptoms, the auxiliary examination comprehensive to make a correct and timely diagnosis, timely treatment to reduce the mortality rate.