主动脉夹层58例临床分析

Clinical analysis of 58 cases of aortic dissection

目的探讨主动脉夹层患者的临床特征、诊断方法及治疗方法，以减少误诊率。方法回顾性总结2001年1月至2011年1月大同市第三人民医院收治的58例主动脉夹层患者的诱因、临床表现、诊断和治疗方法。结果58例中伴高血压者占78．8％，动脉粥样硬化者占66．2％；58例主动脉夹层患者胸骨后撕裂样剧痛者占36．2％，螺旋CT和MRI检查有助于快速明确诊断，确诊率可达到100％。结论主动脉夹层患者中高血压等心血管疾病危险因素的患病率较高，疼痛是主要症状表现，CT和MRI是诊断主动脉夹层很好的技术措施。药物治疗的首要问题是稳定高血压和控制心率，手术治疗是彻底治愈的根本方法。

Objective To investigate the clinical characteristics, diagnotic method and thera- peutic approaches of aortic dissection,in order to reduce the rate of misdiagnosis. Methods The causes, clinical manifestations, diagnosis and treatment of the 58 cases of aortic dissection admitted in our hospi- tal from January 2001 to January 2011 were retrospectively summarized. Results There were 78.8% of the patients had a history of hypertension,66. 2% had arteriosclerosis. There were about 36. 2% of AD patients had sudden severe chest pain. Definite diagnosis could be made by Spiral CT and MRI, and the diagnosis rate was 100%. Conclusions Hypertension is more common in AD patients, pain is the most common symptom, CT and MRI are effective for the diagnosis of aortic dissection. The key pharmacologi- cal problem is to make the blood pressure stable and be controlled, and surgery treatment is the method to treat aortic dissection thoroughly.