妊娠合并主动脉夹层临床资料分析

发布时间：2018-03-27 04:39

本文选题：妊娠　切入点：主动脉疾病　出处：《中国全科医学》2015年14期

【摘要】：目的探讨妊娠合并主动脉夹层的危险因素、临床表现、诊断方法及治疗手段。方法查阅中南大学湘雅二医院2010—2013年1 271例主动脉夹层患者的病历资料,筛选出9例妊娠合并主动脉夹层患者的临床资料进行回顾性分析。结果妊娠早期1例,妊娠晚期及产褥期8例;既往有高血压病史者2例,马凡综合征者4例,两者兼有者1例;主要临床表现为胸背部疼痛8例,胸闷、气促1例。主动脉夹层分型采用Stanford分型标准,A型6例,B型3例;诊断方法包括非创伤性血管成像技术(CTA)和胸壁超声心动图(TTE)。Stanford A型患者1例保守治疗,余5例均采取以Bentall术为基础的手术治疗,3例产妇及胎儿均存活;Stanford B型患者行主动脉夹层带膜支架腔内修复术,产妇及胎儿均存活。结论妊娠合并主动脉夹层好发于妊娠晚期及产褥期,危险因素包括处于妊娠晚期及产褥期、合并高血压或马凡综合征等,临床表现以突发胸背部疼痛为主,诊断方法主要有TTE及CTA等,治疗方案应权衡产妇及胎儿情况、主动脉夹层分型等来综合考虑。
[Abstract]:Objective to investigate the risk factors, clinical manifestations, diagnosis and treatment of aortic dissection in pregnancy. Methods the medical records of 1 271 patients with aortic dissection from 2010 to 2013 in Xiangya second Hospital of Central South University were reviewed. The clinical data of 9 cases of pregnancy complicated with aortic dissection were retrospectively analyzed. Results there were 1 case of early pregnancy, 8 cases of late pregnancy and puerperium, 2 cases of history of hypertension and 4 cases of Marfan syndrome. The main clinical manifestations were thoracic back pain in 8 cases, chest tightness in 1 case, and shortness of breath in 1 case. Aortic dissection was classified according to Stanford classification standard in 6 cases with type A and type B in 3 cases. The diagnostic methods included non-traumatic angiography (CTAA) and chest wall echocardiography (TTE.Stanford A). The remaining 5 cases were treated by Bentall's operation. 3 cases of parturient and 3 cases of fetal survival were treated with endovascular repair of aortic dissection with stent. Conclusion Aortic dissection is common in late pregnancy and puerperium. The risk factors include late pregnancy and puerperium, hypertension or Marfan syndrome, etc. The main diagnostic methods are TTE and CTA. The treatment should balance the maternal and fetal conditions, aortic dissection classification and so on.
【作者单位】：中南大学湘雅二医院急诊科;
【分类号】：R714.252

【共引文献】