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目的提高临床医师对主动脉夹层的认识及诊断率。方法对42例主动脉夹层患者的病因及诱因、临床表现、辅助检查、诊断方法及治疗转归等进行回顾性分析。结果42例患者中39例首发症状为疼痛,疼痛部位以胸、腹部为主34例(81.0%),疼痛性质以撕裂样剧痛为主36例(85.7%);有高血压病史者28例,占66.7%;误诊疾病复杂多样,以冠心病居多,占23.8%,误诊时间最短3h,最长达27h,平均(12.3±4.6)h,首诊误诊率57.1%;34例内科药物治疗的患者,好转26例,死亡8例;介入治疗8例,好转6例,死亡2例。结论因撕裂范围不同,组织供血障碍范围不同,临床表现复杂多样极易漏诊误诊。
Objective To improve clinicians’ understanding and diagnosis of aortic dissection. Methods The etiology, inducement, clinical manifestations, auxiliary examination, diagnosis and treatment of 42 patients with aortic dissection were analyzed retrospectively. Results The first symptom of 39 cases was pain in 42 cases, 34 cases (81.0%) were mainly chest and abdomen in pain area, and 36 cases (85.7%) had severe pain in tibia. The history of hypertension was 28 Cases accounted for 66.7%; Misdiagnosis of the disease complicated and diverse, mostly coronary heart disease, accounting for 23.8%, the shortest misdiagnosis time of 3h, up to 27h, an average of (12.3 ± 4.6) h, the first misdiagnosis rate of 57.1%; 34 cases of medical treatment Of patients, improvement in 26 cases, 8 cases of death; interventional treatment in 8 cases, 6 cases of improvement, 2 cases of death. Conclusion Due to the different tearing range, the scope of blood supply disorder is different, the clinical manifestations are complex and diverse, and it is easy to misdiagnosis.