摘要
目的对比分析以神经功能缺损为主要症状的主动脉夹层(AD)和颈内动脉夹层(ICAD)的临床表现,提高内科医师的首诊确诊水平。方法对比分析4例AD患者和3例ICAD患者的临床表现。结果AD可引起脑和脊髓的神经功能缺损,同时伴发多脏器缺血症状,表现为:肝功能异常、急性肾功能不全及腹痛、腹泻等;ICAD不累及脊髓和内脏器官,表现为:脑梗死及局灶症状(如:颈痛、Horner综合征、周围性颅神经麻痹)。结论AD的临床表现基于夹层动脉血肿延伸压迫或假腔堵塞分支动脉开口导致的分支动脉缺血;ICAD的临床表现主要是栓子脱落导致的脑栓塞。对这两种动脉夹层病变基础的认识可指导临床治疗及预后判断。
Objective To comparatively analyze the aortic dissection （AD） and internal carotid artery dissection （ICAD） in which neurologic impairment is the major symptom, in order to improve the physician＇s level in initial diagnosis. Methods Clinical manifestations of 4 eases with AD and 3 cases with ICAD were analyzed retrospectively. Results AD might induce neurologic impairment of brain and spinal cord, which may accompany multiple system organs impairment such as liver dysfunction, acute renal insufficiency, abdominal pain, diarrhea. ICAD did not involve spinal cord and internal organs, its manifestations included cerebral infarction and focal symptoms such as trachelodynia, Homer syndrome, and peripheral cranial palsy. Conclusion The ischemia in the branch artery resulting from hematoma extension compression or pseudocoele from debouchment clogging of the branch artery is the basis for clinical manifestation of AD, while cerebral embolism resulting from embolus exfoliation mainly contributes to the clinical manifestation of ICAD. The recognition of pathological foundations of AD and ICAD can guide clinical treatment and prognosis judgment.
出处
《中国全科医学》
CAS
CSCD
北大核心
2009年第17期1573-1575,共3页
Chinese General Practice
基金
北京市优秀人才培养资助个人项目(20042D0900711)
关键词
主动脉夹层
颈内动脉夹层
神经功能缺损
Aortic dissection
Internal carotid artery dissection
Neurologic impairment
