主动脉夹层132例临床分析

Clinical analysis of 132 cases with aortic dissection

目的探讨主动脉夹层(AD)的易患因素、临床表现、诊疗和预后的影响因素。方法回顾性分析132例AD的临床资料。结果70例(53.0%)为DeBakeyIII型夹层;88例(66.7%)合并高血压病;外伤所致9例(6.8%)。CT血管造影(CTA)诊断AD准确率为100%。AD伴中重度主动脉瓣关闭不全、心包积液、黑矇晕厥、休克、肾功能不全、上肢缺血者住院病死率41.6%,高于住院总病死率22.0%(P<0.05)。结论AD患者临床表现与分型明显相关。急性期CTA优于其它检查。合并有心包积液、黑5晕厥、休克等并发症者预后较差。

Objective To investigate the susceptible factors,clinical manifestations,diagnosis,treatment and prognosis of aortic dissection（AD）.Methods Clinical date of 132 patients with AD were analyzed retrospectively.Results Seventy cases （53.0%） were Debakey type Ⅲ and 88 cases（66.7%） were associated with hypertension.Nine cases（6.8%） were secondary to injury.The accuracy of CT angiography in diagnosing AD was 100%.The mortality of AD cases with complications was 41.6%,which was significantly higher than 22.0% of the in-hospital total mortality rate（P0.05）.Conclusion Clinical symptoms of AD patients are related with the typing of AD.CT angiography is preferable than the other examings for AD diagnosis in acute phase.The mortality of the AD cases with complications is higher.