主动脉夹层的急诊诊治分析

Emergency diagnosis and treatment of aortic dissection

目的:探讨主动脉夹层(Aortic dissection,AD)的早期诊断与急救处理,提高对AD的重视。方法:回顾性分析2007年1月-2010年12月42例AD患者的临床资料,总结AD的诊治方案。结果:首诊正确的23例AD患者均行急诊内科救治,存活17例(73.9%),死亡6例(26.1%),其中确诊后拒绝治疗3例,24 h内均死亡;延误诊断19例,存活7例(36.8%),死亡12例(63.2%),其中转运途中死亡2例,纠纷2例。结论:及时准确的急诊诊断AD是治疗的关键,有效急救处理为AD的进一步治疗赢得时间,而有效的医患沟通能减少纠纷发生。

Objective：To discuss the early diagnosis and emergency treatment of aortic dissection（AD） in order to enhance its importance.Methods：The clinical data of 42 patients with AD from January 2007 to December 2010 were retrospectively analyzed and their diagnosis and treatment were summarized.Results：Twenty-three cases of AD were diagnosed correctly in the first time and were received emergency medical treatment,among which 17 cases survived（73.9%）,6 cases died（26.1%） and 3 cases refused the treatment and died within 24 hours.There were 19 cases experienced the delay in the diagnosis,among which 7 cases survived（36.8%）,12 cases died（63.2%） including 2 instant death cases and 2 cases had disputes.Conclusion：Timely and accurate emergency diagnosis can gain the time for further treatment,which is the key to the treatment of AD.Meanwhile,effective doctor-patient communication can reduce the disputes.