主动脉夹层的误诊原因分析

Analysis on misdiagnosis reason of the aorta dissection

目的分析主动脉夹层的常见误诊原因,并提出防范措施。方法回顾性分析40例主动脉夹层患者的临床资料。结果 40例患者中,误诊为急性冠脉综合征11例,急性心肌梗死8例,脑血管意外7例,急性肺栓塞6例,胸腰段椎间盘突出症5例,肾绞痛3例,均按误诊疾病治疗,效果差。经综合分析病史、症状、体征、主动脉CT及血管造影(CTA)检查明确诊断。结论行主动脉CTA急诊检查,克服思维惯性,拓展诊断思路,提高对主动脉夹层的早期诊断能力;而详细询问病史,细致的体格检查,有助于防范主动脉夹层的误诊。

Objective To analyze the familiar misdiagnosis reason of the aorta dissection ,and put forward guar‐ding against the measure . Methods Retrospective analytical clinical cases of 40 aorta dissection . Results The 40 cases in our hospital emergency were misdiagnosis ,misdiagnosis were 11 acute coronary syndromes ,8 acute my‐ocardial infarction ,7 cerebrovascular accident ,6 acute pulmonary embolism ,5 intervertebral disc herniation ,3 renal colic .All press misdiagnosed disease treatment effect is poor .Through the comprehensive analysis of the history , symptoms ,signs ,aortic CT angiography （CTA） ,there was a definitive diagnosis . Conclusion Aorta CTA emer‐gency inspection ,overcome the inertia of thinking ,develop diagnostic thinking ,improve their ability to the early di‐agnosis of aortic dissection .Detailed history ,careful physical examination ,helps to prevent the misdiagnosis of aor‐tic dissection .