摘要
目的 探讨主动脉夹层的临床表现 ,急诊诊断及误诊情况。方法 分析 5 3例主动脉夹层临床表现、体格检查、实验室检查及心电图、X线片、CT、B超等辅助检查结果 ,分析急诊诊断的依据及急诊误诊情况。结果 5 3例主动脉夹层临床表现各异 ,部份病例以并发症为首发症状 ,如瘤体破裂造成的急性心脏压塞征、出血性休克 ,亦有主动脉分枝急性闭塞造成器官缺血坏死或压迫所致的单瘫、截瘫、急性左心衰、气胸、中等量以上心包积液 ,是造成本组误诊的主要原因。主动脉夹层系一少见疾病 ,临床医师缺乏对本病的认识也是原因之一。初诊误诊率 2 8%。结论 主动脉夹层临床表现复杂 ,易误诊 。
Objective To study the symptoms and physical signs,diagnosis and misdiagnosis of aortic dissection in emergency department.Methods The symptoms,physical signs,and the results of laboratory test,electrical cardiac gram,X_ray pictures were analyzed.CT,B type ultrosound of 53 patients with aortic dissection were analyzed the diagnosis and misdiagnosis in emergency department.Results The symptoms and physical signs of aortic dissection were different in 53 patients.The symptoms for misdiagnosis were:(1)some patients had such initial symptoms as cardiac tamponade,hemorrhagic shock,monoplegia,paraplegia,acute left heart failure,pneumatothorax,hydrocardia;(2)some doctors knew little about aortic dissection because the disease happened rarely.The misdiagnosis rate was 28%.Conclusion The symptoms and physical signs of aortic dissection are different The disease is easy to be misdiagnosied,and it should be known well by emergency doctors. [
出处
《中华急诊医学杂志》
CAS
CSCD
2003年第9期619-621,共3页
Chinese Journal of Emergency Medicine