主动脉夹层分离30例的临床诊治

The diagnosis and treatment of 30 cases with aortic dissection

目的:探讨主动脉夹层分离(AD)的临床诊疗特点,提出减少对其的误诊率,加强治疗成功率的措施.方法:回顾性总结1996年1月～2002年5月本院收治30例主动脉夹层分离患者的临床资料,29例行内科重症监护治疗,其中3例行外科治疗,1例行介入治疗.使用四格表确切概率法比较A、B两型AD的院内死亡率.结果:门诊误诊6例(20%),其中2例误诊为急性心肌梗死,4例误诊为急腹症.院内死亡11例(A型9例,B型2例),A型死亡率(60%)高于B型(14.29%),其差异有统计学意义(P＜0.05).结论:重视高危人群,熟悉临床特征,擅选辅助检查,可有效降低AD的误诊率,提高生存率.

Objects: To study clinic characteristics of the aortic dissection(AD), reduce the misdiagnosis rate, increase successful rate of treatent and compare the mortality in hospital of A、B types AD.Method: Retrograde analysis clinic data of 30 patients admitted in our hospital from January 1996 to may 2002, 29 cases with AD were in patients and one outpatient Aucong them, 29 cases were treated by medical drugs, 3 cases by surgery, 1 case by intervention. For the mortality in hospital of A、B types AD, we use exact probabilities in 2×2 table. Results: In outpatient, misdiagnosis rate is 20%. The mortality of A type(60%) is significancant higer than B type (14.29%) groups (P<0.05). Conclusion: If we can notice risk factors, clinic characteristics and be good at electing imaging technology, standard medical therapy as soon as you can, ratio of the diagnosis of the aortic dissection can be improved, at the same time, prognosis is associated with different types. A type is poorer than B type.