主动脉夹层动脉瘤患者的急诊观察分析

Patients with aortic dissection in the emergency observation and analysis

目的 探讨主动脉夹层动脉瘤急性期患者的临床特点,明确观察对早期诊断和治疗的重要性.方法 分析43例主动脉夹层的病因、诱因、临床表现、诊断、鉴别诊断及治疗.结果 主要首发症状为左背部持续剧烈疼痛,增强CT诊断符合率高（100%）,内科保守治疗29例,血管内介入治疗2例,外科成功进行手术l0例,随访3～35个月,临床症状均消失或减轻,无再发夹层,死亡2例.结论 以突发胸痛就诊,应考虑主动脉夹层的诊断,增强CT是确诊主动脉夹层的首选方法,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 Acute aortic dissection in patients with clinical features, a clear observation of the importance of early diagnosis and treatment. Methods 43 eases of aortic dissection causes,incentives, clinical manifestations, diagnosis, differential diagnosis and treatment. Results Main initial symptoms severe pain left back continued, enhanced CT diagnostic rate （100%）, conservative medical treatment in 29 cases, 2 cases of endovascular treatment, surgical 10 successful surgery were followed up for 3-35 months, the clinical symptoms disappeared or reduced recurrence-free sandwich, 2 died. Conclusion Treatment of sudden chest pain should be considered in the diagnosis of aortic dissection, enhanced CT is the preferred method for diagnosis of aortic dissection, the most important issue of drug treatment of high blood pressure and control of heart rate is stable, surgical treatment is complete cure of the basic method.