【作者】 安丰慧；

【导师】 买苏木·马合木提；

【作者基本信息】 新疆医科大学 ， 内科学， 2009， 硕士

【摘要】 目的:探讨主动脉夹层(AD)患者的基本情况、临床特征、误诊及辅助检查对诊断的意义和治疗情况。方法:对我院239例确诊为AD的临床资料做回顾性分析。结果:高血压是导致AD发生的常见原因,AD患者临床表现多样,胸痛为常见首发表现,部分病例以并发症为首发,以心肌梗塞为首发表现的夹层破口多位于升主动脉,以肩背部为首发疼痛累及腰腹或下肢者,夹层破口多位于降主动脉.部分患者亦合并心包积液、胸腔积液、主动脉瓣关闭不全等。超声, CT和MRI三种辅助检查各有缺点,三者联合应用有利于快速诊断和定位,以减少病死率,其中超声检查因为其准确率较高,价格便宜,技术要求不高,故有疑诊病人,常规做超声。AD的治疗现在有内科保守治疗,外科手术治疗和新兴的血管内带膜支架治疗,其中后者显示了很好的前景。结论:高血压是AD的主要危险因素,其临床表现复杂多变,误诊率高,患者的症状与夹层破口有一定的关系。正确诊断和积极的内科治疗以及根据患者分型和病情采取外科手术、介入治疗可减少病死率和改善患者的预后。更多还原

【Abstract】 Objetives: To explor the basiec charaeteristies,clinieal features,misdiagosis examination methords of aortia dissectiao(AD) and treatment of aortic dissection (AD). Methods: Retrospective analysis of clinical records of 239 patientes with AD. Results: Hypertension was the most important caust of AD,The symptoms and physical signs of the 239 AD patients were diverse,chest pain was a common initial symptoms but some pations initial symptoms were atypical. Some patients with AD had complications such as pericardial effusion,pleural effusion,aortic regurgitation and so on. The echocardiography CT and MRI had their characters. But the combinon of them may help to make rapid diagnosis.We find the echocardimgraohy was the best examination methods for its cheap prise and better accur .There are Surgery,interventional stenting or medial therapy for AD,in whidh the interventing had good applied perspective. Conclusion: Hypertension was the most important cause of AD. Symptoms of AD are complicated and variable, resulting in a high misdiagnosis rate .clinical symptom had some relationship with the origin of AD.surgery,interventional stenting or medical therapy for AD depends on accurate diagnosis, actiue medical therapy or the types of AD .更多还原