主动脉夹层的临床特点及诊治方法

发布时间：2018-10-29 11:53

【摘要】：目的：探讨主动脉夹层的临床特点及诊治方法。方法：回顾性分析我科近5年收治的68例主动脉夹层患者的病因和诱因、临床表现、辅助检查结果、诊断分型、治疗方式及效果。术后定期复查主动脉增强CT及三维重建,同时采用电话、门诊及住院复查等随访方式,随访内容主要包括血压及心率控制情况、瘤体的形态变化、并发症及存活率等。结果：68例主动脉夹层中,Stanford A型21例,Stanford B型47例。高血压是该病最主要的高危因素,多数以胸背部疼痛为首要症状,主动脉增强CT及三维重建有助于明确诊断。本组中17例行外科手术治疗,术后死亡2例(11.8%)；43例行覆膜支架人工血管腔内隔绝术,术后发生内瘘2例(4.7%),死亡1例(2.3%)。术前死亡5例(7.3%),自动出院3例(4.4%)。其余随访患者术后未出现与主动脉夹层及手术相关的并发症,总体生存质量好。结论：早期诊断并及时合理的治疗是改善主动脉夹层患者预后的关键。
[Abstract]:Objective: to investigate the clinical features, diagnosis and treatment of aortic dissection. Methods: the etiology and inducement, clinical manifestation, auxiliary examination results, diagnosis and classification, treatment method and effect of 68 patients with aortic dissection were retrospectively analyzed. CT and 3D reconstruction of aorta were reexamined regularly after operation, and telephone, outpatient and inpatient reexamination were used to follow up, including blood pressure and heart rate control, morphologic changes of tumor, complications and survival rate. Results: among 68 cases of aortic dissection, 21 cases were, Stanford A type and 47 cases were, Stanford B type. Hypertension is the most important high risk factor of the disease. Chest and back pain is the main symptom. Enhanced CT and 3D reconstruction of aorta are helpful for diagnosis. 17 cases were treated surgically, 2 cases died (11.8%), 43 cases underwent endovascular graft, 2 cases (4.7%) had internal fistula and 1 case (2.3%) died. 5 cases (7.3%) died before operation, 3 cases (4.4%) were discharged automatically. There were no postoperative complications related to aortic dissection and operation in other patients, and the overall quality of life was good. Conclusion: early diagnosis and timely and reasonable treatment are the key to improve the prognosis of aortic dissection.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.3

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