【摘要】 目的了解急性升主动脉夹层的临床特征以及急诊外科手术和内科药物治疗对此类患者预后的影响。方法对112例急性升主动脉夹层患者的临床资料进行分析,将纳人研究的病例分为药物治疗组和急诊外科手术治疗组,分析两组患者的发病特征、住院并发症的发生率以及病死率等指标。结果98例患者首发症状为颈、胸、背部"撕裂"样难以忍受的剧烈疼痛,78例患者既往有高血压病史,18例为马凡综合征患者,112例患者中有33例(29%)于住院期间死亡;58例急性A型夹层患者行药物治疗,另外54例患者经确诊后行急诊外科手术治疗,药物治疗组有23例(40%)患者死亡,而手术治疗组10例(19%)患者死亡,两组差异有统计学意义(P<0.001)。结论急性升主动脉夹层有很高的住院病死率和严重并发症的发生率,行急诊外科手术可明显降低患者的病死率,改善患者的预后。更多还原

【Abstract】 Objective To evaluate the clinical characteristics and outcomes of different treatments of patients with acute type A aortic dissection.Methods A retrospective.monocentic study of 112 patients were adminstered for acute A aortic dissection.Different treatment modalities including drug therapy and surgical resection were per- formed in 58 and 54 cases of acute type A aortic dissection.Clinical features,in-hospital complications and mortality rate were analyzed.Results A majority of patients had hypertension and presented with abrupt onset chest or back pain.Marian syndrom was exclusively associated with dissection in the young.The overall mortality rate was close to 29 % mainly as a result of aortic dissection rupture and organ malperfusion.The in-hospital mortality rate in conser- vative drug therapy group was 40 % and was 19 % in surgical resection group(P<0.001).Conclusion The present study shows that in-hospital mortality rates in patients with type A aortic dissection remain high,even in centers that have extensive expertise and interest in the treatment of those high-risk patients.Surgical resection is superior to drug therapy in the treatment of acute type A aortic dissection.更多还原