【摘要】 目的：探讨无痛性主动脉夹层的临床诊治情况。方法：收集81例无痛性主动脉夹层病例进行统计分析。结果：按时间跨度分成两组：2009年至2014年为A组29例，2015年至2020年为B组52例，下列指标两组间差异有统计学意义（P<0.05）：以神经系统症状首诊的比例（27.6%vs.51.9%），从首诊到确诊的时间超过48h比例（72.4%vs.32.6%），保守治疗比例（62.1%vs.26.9%），在院病死率（41.4%vs.19.2%）。以临床症状分为神经系统症状及非神经系统症状两组，神经系统症状组A型夹层比例（71.4%vs.36.9%）及病死率（40.0%vs.17.4%）均高于和非神经系统症状组（P<0.05）。以治疗方案分保守治疗组和非保守治疗组，保守治疗组病死率（46.8%）高于非保守治疗组（14.3%,P<0.05）。结论：无痛性主动脉夹层发病凶险，随着诊断和手术治疗水平的提高，得到及时诊治，病死率明显下降。更多还原

【Abstract】 Objective: To demonstrate clinical diagnosis and treatment of painless aortic dissection.Methods: A total of 81 cases of painless aortic dissection were recruited in this study. Results: All cases were divided into two groups by time span. Twenty-nine cases were included in group A(from 2009 to 2014), and fifty-two were in group B(from 2015-2020). The difference in the following clinical data was significant between two groups: the proportion of patients with first presentation of neurological symptoms(27.6% vs.51.9%), the proportion of patients who were diagnosed as painless aortic dissection beyond 48 hours after the occurence of the first symptom(72.4% vs.32.6%), the proportion of patients with conservative treatment(62.1% vs.26.9%), mortality in hospital(41.4% vs.19.2%). All cases were divided into two groups by symptoms. The proportion of type A dissection(71.4% vs.36.9%) and mortality in hospital(40.0% vs.17.4%) were significantly higher in neurological symptom group than in nonneurological symptom group(P<0.05). All cases were divided into two groups by treatments. Mortality was significantly higher in conservative group(46.8%) than in non-conservative group(14.3%, P<0.05).Conclusions: Painless aortic dissection is a catastrophic disease with high mortality. With the development of diagnosis and treatment, timely diagnosis and treatment helps to improve survival rate.更多还原