临床误诊误治2018，Vol.31Issue(2)：1-5,5.DOI:10.3969/j.issn.1002-3429.2018.02.001
急性主动脉夹层168例临床诊治分析
Analysis of Diagnosis and Therapy of 168 Cases with Acute Aortic Dissection
罗常有 1王善花 1陈本发 1熊赖焱 1姜华丽1
作者信息
- 1. 523110广州 东莞,中山大学附属东华医院心血管内科
- 折叠
摘要
Abstract
Objective To investigate the misdiagnosis, therapy and prognosis of acute aortic dissection (AAD). Methods Clinical data of 168 cases with AAD from January 2004 to June 2016 in Donghua Hospital affiliated to Sun Yat-sen University were retrospectively analyzed. Results The male to female ratio was 5.46: 1, ages were 20-91 (51.22 +14.44) years,with an average duration from onset for 4 h. All were diagnosed by aortic CT angiography(CTA). There were 87 cases (51.79%) of type I,20 cases(11.90%) of type II and 61 cases(36.31%) of type III according to the Debakey Classification. Chest (backache) pain was the common primary symptoms in 128 cases (76.19%). 61 cases (36.31%) were misdiagnosed initially,with a duration from onset for 1-24(10.5 ± 7.4) h. Acute myocardial infarction was the most common misdiagnosis,followed by chronic kidney disease. 50 cases stayed in hospital within 1 day, with 86 cases no more than 4 days. There was a higher in-hospital mortality rate for patients initially admitted to the other departments rather than the Department of Cardiology with a significant statistical difference (P<0.05). 107 cases including DeBakey I and II received conservative treatment,18 cases died in DeBakey I group and 1 in DeBakey II. Among the 61 cases by DeBakey III,18 cases received endovascular repair and 1 died,another 43 received conservative treatment and 3 died. Compare to conservative treat-ment,endovascular repair did not reduce the incidence of in-hospital death in patients by DeBakey III(P>0.05 ). Conclu-sion The incidence of AAD is increasing year by year,with misdiagnosis a severe problem. For patients by DeBakey III,en-dovascular repair is not superior to conservative treatment on short-term survival in hospital.关键词
动脉瘤,夹层/误诊/心肌梗死Key words
Aneurysm,dissecting/Misdiagnosis/Myocardial infarction分类
医药卫生引用本文复制引用
罗常有,王善花,陈本发,熊赖焱,姜华丽..急性主动脉夹层168例临床诊治分析[J].临床误诊误治,2018,31(2):1-5,5.
