【摘要】 目的回顾性分析主动脉夹层分离(AD)的易患因素、临床表现、诊断和治疗。方法对2000年1月至2008年7月连续确诊的114例AD患者的临床资料、治疗情况进行分析,总结诊治经验。结果本研究114例AD患者中95例(83.3%)有高血压病史,以疼痛为首发症状占103例(90.4%)。超声、CT、MRI、主动脉造影(DSA)检查的阳性率分别为60.0%、94.1%、96.6%、100%。确诊后经内科保守治疗78例,外科手术11例,支架植入术25例,其院内、发病后1年、2年、3年以上的总生存率分别为75.4%,66.7%,64.9%,63.2%,其中内科治疗组的生存率分别为66.7%、53.8%、51.3%,51.3%,外科手术组的生存率均为81.8%,支架植入术组的生存率分别为100%、100%、100%、92.0%。结论高血压是AD的主要病因,疼痛是常见的首发症状。超声、CT、MRI 3种技术联合运用有助于AD的诊断和定位,快速诊断和及时的标准化治疗是提高生存率的关键。并且,根据临床分型和病情进行外科或介入手术治疗可明显提高生存率,改善预后。更多还原

【Abstract】 Objective Retrospective analysis was made on risk factors,clinical manifestations,diagnosis and treatment of aortic dissection(AD).Methods The clinical data,treatment conditions in 114 confirmed patients of AD from January 2000 to July 2008 were summarized and analyzed to conclude experience in diagnosis and treatment.Results In this study,there were 95 AD patients(83.3%) had a history of hypertension,and pain as the first symptom of 103 cases(90.4%).The positive rates of ultrasound,CT,MRI,DSA were as follows:60.0%,94.1%,96.6%,100%.There were 78 cases for conservative treatment,11 cases for surgery,25 cases for stent implantation.During the hospital and after the onset of 1,2,3 or more years,overall survival rates were 75.4%,66.7%,64.9%,63.2%,of which the rates in medical treatment group were as follows:66.7%,53.8%,51.3%,51.3%,the rate in surgical group was 81.8%,but the rates in stenting group were 100%,100%,100%,92.0%.Conclusion Hypertension is a major cause of AD,the pain is the most common first symptom.Ultrasound,CT,MRI joint use help quick diagnosis and positioning,and timely and effective standard treatment is the key to improving survival,according to clinical classification,surgery or interventional procedures can significantly improve survival rate and improve prognosis.更多还原