主动脉夹层动脉瘤临床特点及早期诊断体会(附33例报告)

目的：探讨主动脉夹层动脉瘤患者的临床表现及体格检查特征。以提高早期诊断水平。方法：通过33例主动脉夹层动脉瘤临床资料的总结，分析主动脉夹层动脉瘤患者临床特点及各特有体征的发生率。结果：33例中21例有明显的高血压病史(63．64％)，24例表现为剧烈的疼痛(72．72％)。疼痛部位：心前区15例(45．45％)。肩背部12例(36．36％)，腹部7例(21．21％)，腰部1例(3．03％)。33例中28例可听见明显的周围血管杂音(84．85％)。杂音部位：颈部杂音或合并有颈部杂音者21例(63．64％)；胸背部或合并胸背部杂音者15例(45．45％)；腹部杂音或合并有腹部杂音者13例(39．39％)；腰部杂音或合并有腰部杂音者5例(15．15％)。结论：主动脉夹层动脉瘤临床表现复杂，掌握临床表现及体格检查特点是提高诊断率的关键。

The clinical characters and primary diagnosis of aortic dissection aneurysm

Objective: To study the clinical characters of aortic dissection aneurysm(AD) for evaluate the diagnostic levels. Method: The clinical features of 33 patients with AD were studied , including clinical manifestations, the proportions of physical signs . Result: Among 33 patients with the AD , 21cases have obvious hypertension history(63.64%); The initial symptoms were bursting pain in 24 cases(72.72%);The position of pain: precordial , 15 cases(45.45%) ; shoulder back , 12 cases(36.36%); Abdominal ,7 cases(21.21%) ; Lumbar , 1 cases (3.03%). 28 cases have obvious peripheral vascular murmur (84.85%). The position of murmur : cervical , 21 cases(63.64%); Chest back ,15 cases(45.45%); Abdominal, 13 cases(39.39%); Lumbar , 5 cases(15.15%). Conclusion: The symptoms and physical signs of the AD are different . To evaluate the diagnostic levels, it is important to recognize its clinical characteristic.