679例主动脉夹层临床特点的回顾性分析

Retrospective analysis of clinical features of 679 cases of aortic dissection

目的：回顾性分析679例主动脉夹层（aortic dissection,AD）患者临床特点、治疗方法及转归,为提高相关科室医护人员对AD临床特征的全面认识、减少漏诊、误诊率、及时实施有效措施提供依据。方法：对武汉市某三甲医院2010-01-2013-03收治的679例AD临床特点、治疗方法及转归进行回顾性分析。结果：共收集病例679例,男535例,女144例,年龄19-91（53.23±11.80）岁,608例（89.54%）患者以剧烈疼痛为首发症状,初诊漏诊、误诊85例（12.52%）;采用保守治疗患者占49.19%（334/679）;死亡病例69例（10.16%）,其中Ⅰ型占56.52%（39/69）,其病死率为19.21%（39/203）。结论：AD发病人数呈逐年增多的趋势,发病人群年轻化,具有较高的漏诊、误诊率及病死率,有必要增强相关科室医护人员对AD疾病的全面认识并保持高度警惕性。

Objective：We retrospectively analyze the clinical features,treatment and prognosis of 679 aortic dissection （aortic dissection, AD） patients, in order to improve the overall understanding of the relevant sections of the clinical features of AD,reduce misdiagnosis rate, and timely implement effective measures. Method： We retrospectively analyzed the clinical features, treatment and outcome of 679 cases of AD patients admitted to a hospital in W uhan from January 2010 to March 2013. Result：679 cases of AD patients were collected, 535 cases of male and 144 cases female,the average age were 19-91 （53.23 ± 11.80） years old. The first symptom of 608 cases （89. 54%） were severe pain,and 85 eases were misdiagnosed（12.52%）. Patients who used conservative treatment accounted for 49.19% （334/679）. 69 cases dead （10.16%）,and type I patients accounted for 56. 52% （39/69）,and its mortality rate was 19. 21%（39/203）. Conclusion： The incidence of AD showed an increasing trend year by year. The onset of the disease tends to be young, with a high incidence of misdiagnosis and mortality. It is necessary to enhance the overall understanding of AD diseases for health care workers.