主动脉壁内血肿15例误诊分析

Analysis on misdiagnosis of 15 patients with aortic intramural hematoma

目的了解主动脉壁内血肿（AIH）误诊的现状，提高对AIH的诊断认识。方法收集我院2002年以来误诊为其他疾病的15例主动脉壁内血肿住院患者资料，对被误诊的15例AIH患者的误诊疾病、临床表现、辅助检查等进行回顾性调查研究。结果AIH患者临床症状多样，疼痛症状发生率最高（87％），以胸背痛居首，腹痛为其次。误诊疾病达8种，前4种疾病依次为冠心病、急腹症、中枢神经系统病变和尿路结石。结论AIH的临床表现复杂，不具备特异性。AIH的误诊率高，误诊的疾病种类繁多。对胸痛、周围动脉阻塞征象、伴或不伴高血压的患者。应提防AIH的可能。结合影像学检查，可提高诊断率。

Objective To study the present situation of misdiagnosed aortic intramural hematoma（AIH） and to improve the comprehension for aortic intramural hematoma. Methods Misdiagnosed AIH from 2002 was collected, the misdiagnosed diseases, clinical manifestations and auxiliary examinations in 15 patients with aortic intramural hematoma were studied retrospective. Results The patients with AIH had diversiform clinical manifes- tations. The incidence rate of pain was highest （87%）, among which chest-back pain was the first manifestation and abdomen pain was the second. The misdiagnosed diseases reached 8 kinds. The first four kinds successively were： coronary heart disease, acute abdominal disease, central nerve disease and lithangiuria. Conclusion The manifestations of AIH are complicated and nonspecific. The misdiagnosis rate in AIH is high and the kinds of misdiagnostic diseases are various. Patients who have pain, signs of obstruction of artery, with hypertension or not should be considered to AIH. In clinical practice, imaging examinations can help diagnose.