【摘要】 目的提高主动脉夹层(aortic dissection,AD)首诊检出率。方法回顾我院2014年1~12月已经确诊的AD患者142例,对其临床表现及代表其撕裂范围的病理解剖分型进行匹配性检查,若符合病理生理,则判断为匹配。否则判断为不匹配。结果 AD的临床表现均与代表其撕裂范围的病理解剖分型匹配。结论 AD临床表现由随时间变化的主动脉撕裂范围、分支血管受累程度所决定,应从病理解剖角度提高AD临床表现多样化的认识;尽量用"一元论"诊断去网罗各种复杂多变的临床表现;用降阶梯诊断思维优先排外主动脉夹层;若无条件限制,选择检查的优先顺序为:CTA或MRI,CT平扫或彩超。更多还原

【Abstract】 Objective To improve the initial diagnosis detection rate of aortic dissection(AD). Methods 142 patients diagnosed with AD in our hospital from January to December of 2014 were reviewed, and matching examination was conducted between their clinical manifestations and the pathological anatomy types representing their tear ranges. If the clinical manifestation accorded with the pathophysiology, a match was decided, or else a mismatch was decided. Results All the AD clinical manifestations matched the pathological anatomy types representing their tear ranges. Conclusion The AD clinical manifestation is determined by the time-dependent aorta tear range and branch vessel involvement degree, and therefore understanding of the diversity of AD clinical manifestations should be improved from the aspect of pathological anatomy. The "monism" diagnosis should be used to collect a variety of complex and changeful clinical manifestations. The down-stepped diagnosis thought should be used to exclude the aortic dissection first. If without preconditions, the preferred examination order should be CTA or MRI and CT plain scan or color ultrasound.更多还原