【作者】 胡鹏；

【导师】 李强；

【作者基本信息】 重庆医科大学 ， 外科学， 2015， 硕士

【摘要】 目的：探讨主动脉夹层的临床特点及诊治方法。方法：回顾性分析我科近5年收治的68例主动脉夹层患者的病因和诱因、临床表现、辅助检查结果、诊断分型、治疗方式及效果。术后定期复查主动脉增强CT及三维重建,同时采用电话、门诊及住院复查等随访方式,随访内容主要包括血压及心率控制情况、瘤体的形态变化、并发症及存活率等。结果：68例主动脉夹层中,Stanford A型21例,Stanford B型47例。高血压是该病最主要的高危因素,多数以胸背部疼痛为首要症状,主动脉增强CT及三维重建有助于明确诊断。本组中17例行外科手术治疗,术后死亡2例(11.8%)；43例行覆膜支架人工血管腔内隔绝术,术后发生内瘘2例(4.7%),死亡1例(2.3%)。术前死亡5例(7.3%),自动出院3例(4.4%)。其余随访患者术后未出现与主动脉夹层及手术相关的并发症,总体生存质量好。结论：早期诊断并及时合理的治疗是改善主动脉夹层患者预后的关键。更多还原

【Abstract】 Objective To investigate the clinical character, diagnosis and treatment of aortic dissection.Methods Clinical data of the pathogeny, inducement, clinical manifestation, accessory examination, diagnostic classification, treatment methods and effect of 68 patients with aortic dissection in recent five years were retrospectively analyzed. Postoperative regularly review the aortic enhancement CT and three-dimensional reconstruction, at the same time using the telephone, and follow-up outpatient and hospitalization review methods, content mainly including blood pressure and heart rate control, the morphology of tumors, complications and survival rates, etc.Results Stanford type A in 21 cases, Stanford type B in 47 cases. Hypertension was the main high risk factor, the first symptom for most of patients was the Chest and back pain. Enhanced spiral CT scans and three dimensional reconstruction of aorta were benefit to diagnose definitely. Among 17 cases proceeded with cardiothoracic surgical treatment,2 cases(11.8%) died.43 cases were performed endoluminal stent-graft implantation, and 2 cases(4.7%) occurred endoleak, one case(2.3%) died.5 cases(7.3%) died of before operation,3 cases(4.4%) auto-discharged. By Follow-up the remaining patients, we found that no one appeared the related complications of aortic dissection or operations and owned a good total life quality.Conclusions Early diagnosis and reasonable treatment in time are the key to improve the prognosis of patients with aortic dissection.更多还原