主动脉夹层48例早期诊断与治疗

Early diagnosis and therapy of aortic dissection in 48 cases

目的探讨主动脉夹层(aortic dissection,AD)早期诊断线索和方法,选择合理治疗手段。方法回顾性分析2005年1月～2010年5月48例主动脉夹层患者的临床资料。结果根据患者发病特点,早期选择合理的影像学检查,有助于快速诊断,尤其增强螺旋CT、磁共振成像(MRI)诊断符合率最高。本组患者内科保守治疗32例,外科人工血管置换术12例,腔内带膜支架植入术4例,治愈30例,死亡18例。结论对于AD患者早期快速诊断及选择合理的治疗方案是提高生存率的关键。

Objective To explore the clues and methods in early diagnosis and therapy of aortic dissection, and choose the reasonable ways of treatment. Methods Retrospective analysis 48 cases of aortic dissection from January 2005 to May 2010. Results According to the onset characteristics of patients with aortic dissection, the early selection of the reasonable imaging examination will help the doctors make rapid diagnosis. Diagnostic accordance rate of enhanced spiral CT and Magnetic Resonance Imaging was higher than other methods. In all patients ,32 cases were gave medical conservative treatment, 12 cases were gave Artificial Vascular Replacement, 4 cases were gave Endovascular Stent - graft Implantation. Finally 30 cases were cured and 18cases were dead. Conclusion For patients with aortic dissection , the key of increase survival rate was early repid diagnosis and reasonable therapeutic scheme.