主动脉夹层临床分析

Clinical Analysis of Aortic Dissection

目的:评价不同的入院确诊时间和治疗方法对主动脉夹层疗效的影响。方法:对140例主动脉夹层患者进行确诊主动脉夹层时间的分组和分析早期误诊的原因。回顾分析药物、手术及支架植入治疗的疗效。结果:5h内确诊20例(14.3%),5～12h内确诊18例(12.9%),12～24h内确诊14例(10%),24h后确诊的有88例(62.8%)。早期误诊为其他疾病的病例有63例(45%)。药物治疗组92例,住院死亡18例(19.6%);手术治疗组20例,住院死亡7例(35.0%);支架治疗组28例,住院死亡1例(3.6%)。结论:主动脉夹层早期误诊率高,应引起关注。支架置入治疗III型主动脉夹层疗效较好。

Objective：To evaluate the effects of the time needed in final diagnosis and different treatments on clinical outcomes in aortic dissection patients（AD）. Methods：One hundred and fourty patients with AD were divided into four subgroups according to the time needed to establish the diagnosis of aortic dissection. Effects of drug therapy, surgical resection and stent implantation were analyzed respectively. Results： Twenty cases （14. 3 %） were diagnosed within 5 hours,18 cases （12. 9%） were diagnosed in 5 to 12 hours, 14 cases （10%） were diagnosed in 12 to 24 hours,88 cases （62. 8%） were diagnosed after 24 hours. Sixty-three （45%） cases were misdiagnosed in the early stage. The hospital mortality in drug therapy group was 19. 6%, surgical resection group was 35 %, stent implantation group was 3.6%. Conclusion：The misdiagnosis rate of aortic dissection is high, stent-graft is effective and safe in treatment of acute stanford typeⅢ aortic dissection.