摘要
目的探讨急性主动脉夹层的易患因素、临床特点和基层医院救治策略。方法选择遂宁市中心医院2008年1月～2013年9月收治的急性主动脉夹层患者142例临床资料进行回顾性分析，研究其临床特点、影像学表现、治疗方式及效果。结果按Stanford分型，StanfordA型41例，StanfordB型101例。外伤所致2例，食管异物刺伤胸主动脉2例，马凡综合征2例，高血压者136例；所有病例均通过心脏大血管增强cT造影确诊。142例中完全内科保守治疗80例，死亡59例，自动出院放弃治疗11例；1例行开窗技术治疗；1例行杂交手术治疗：44例行主动脉腔内修复术，死亡1例，持续发热1例；外科手术治疗16例，死亡3例。结论本病死亡率高，原发性高血压为最常见的高危因素之一。对于主动脉夹层患者一经确诊，应在积极内科保守治疗的同时，根据不同的类型及并发症采取相应的外科手术、主动脉腔内修复术或杂交手术治疗，可显著提高患者的存活率。
Objective To discuss the risk factors, clinical characteristics and basic hospital treatment strategy of acute aortic dissection. Methods A retrospective analysis was made on the clinical data of 142 acute aortic dissection pa- tients Central Hospital of Suining City from January 2008 to September 2013 were selected. The clinical characteris- tics, imaging manifestations, treatment method and effect were analyzed. Results According to Stanford types, 41 cases of Stanford A, I01 cases of Stanford B were found. 2 cases of trauma, 2 cases of thoracic aortic puncture, 2 cases of Marfan syndrome, 136 cases of high blood pressure were found. All the cases were confirmed by heart vascular en- hancement CT angiography. 80 cases with complete internal medicine conservative treatment, 59 cases of death, 11 cases of hospital discharge automatically were found. 1 case with fenestration treatment, 1 case with hybrid operation treatment were found. 44 cases with endovascular repair, 1 case of death, 1 case with continuous fever were found. 16 cases with surgical treatment and 3 cases of death were found. Conclusion This disease has a high death rate and one of the high risk factors is primary hypertension. It is right to take the corresponding surgical operation, endovascular repair or hybrid operation according to different types and complications while carrying out conservative medical man- agement actively to improve the patients＂ survival rate.
出处
《中国医药导报》
CAS
2014年第12期32-35,共4页
China Medical Herald
基金
四川省卫生厅科研课题项目(编号130491)
关键词
主动脉夹层
临床分析
三分支主动脉支撑型覆膜支架
主动脉腔内修复
Acute aortic dissection
Clinical analysis
Triple-branched aortic arch covered stent graft
Thoracic En-dovascular aortic repair
