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目的:研讨主动脉夹层临床表现及诊治现状。方法:收集1995年5月-2008年2月140例主动脉夹层患者临床资料,其中2005年3月以前45例、以后95例,分析其临床特点、影像学诊断、治疗方法及效果。结果:①主动脉夹层多发于中老年男性,多集中在40~60岁,10~12月发病水平较高。②发病与高血压病、吸烟和马凡综合症相关。③突发胸、腹部剧烈、持续疼痛是本病的主要临床表现。④影像学MRI、CTA和DSA检查是确诊本病的最佳方法,诊断符合率达100%。⑤早期及时确诊,降低血压、心率是关键,手术患者预后好,生活质量较高。结论:主动脉夹层首发症状主要为持续剧烈胸腹疼痛,死亡率高,早期诊断是治疗关键,MRI、CTA及DSA有助于确诊,在有效内科治疗基础上及时手术或介入治疗是降低死亡率的有效方法。
Objective: To study the clinical manifestations and diagnosis and treatment of aortic dissection. Methods: The clinical data of 140 patients with aortic dissection between May 1995 and February 2008 were collected, including 45 cases before March 2005 and 95 cases afterwards. The clinical features, imaging diagnosis, treatment methods and effects were analyzed. Results: ①Aortic dissection occurred in middle-aged men, mostly concentrated in 40 to 60 years old, 10 to 12 months the higher the incidence. ② incidence and hypertension, smoking and Marfan syndrome related. ③ sudden chest, abdominal severe, persistent pain is the main clinical manifestations of the disease. ④ imaging MRI, CTA and DSA examination is the best way to diagnose the disease, the diagnostic coincidence rate of 100%. ⑤ early diagnosis in a timely manner, lower blood pressure, heart rate is the key, the prognosis of surgery patients with good quality of life higher. Conclusions: The first symptom of aortic dissection is persistent severe chest and abdomen pain. The mortality rate is high. Early diagnosis is the key point of treatment. MRI, CTA and DSA are helpful to diagnose. On the basis of effective medical treatment, timely operation or intervention is to reduce mortality Effective method.