主动脉夹层的特殊临床表现及诊治体会

Clinical Diagnostic and Management Perspectives of Aortic Dissection

目的：分析主动脉夹层（aorticdissection，AD）的特殊临床表现及诊治体会。方法：对28例AD患者的临床诊治进行回顾性分析。结果：经控制血压、镇痛等内科治疗后有22例血压降至理想水平，疼痛症状明显改善；另有3例患者症状无明显改善；1例转上级医院经外科人工血管置换术后疼痛等症状消失，手术成功；2例治疗效果不佳分别死于发病后1～50内，其死因均为急性夹层动脉瘤破裂。结论：及时把握AD临床表现。早期准确诊断并积极治疗是改善AD患者预后的关键。

Objective：Analysis of aortic dissection （aortic dissection, AD） special clinical manifestations and diagnosis and treatment experience. Methods： 28 cases of AD patients in clinical diagnosis and treatment were retrospectively analyzed. Results： By the control of blood pressure, 22 cases of analgesia after medical treatment such as blood pressure fell to the ideal level, pain symptoms improved significantly, and 3 patients symptom have no obvious improvement; 1 case turned to higher level hospital pain and other symptoms disappear after artificial vascular replacement surgery, surgical success. 2 case of poor treatment effect respectively within 1 day to 5 day after died of illness, the cause of his death were acute dissection aneurysm rupture. Conclusion： AID in clinical manifestations, early accurate diagnosis and effective treatment is the key to improving the prognosis of patients with AD.