CAJ | 학술논문

目的探讨主动脉夹层死亡患者的临床特点,以降低院内病死率。方法对2004年10月-2013年10月经影像学检查确诊为主动脉夹层且在住院期间死亡的16例临床资料进行回顾分析。结果16例主动脉夹层临床表现多样,如剧烈的心前区疼痛、胸背部疼痛、心悸、憋气、大汗、晕厥等,其中以撕裂样胸背部疼痛多见。本组7例接受外科手术治疗,其中1例术中死亡,余6例死于术后并发症(感染、消化道大出血、多脏器功能衰竭等)。3例行降主动脉覆膜支架植入术,其中2例死于主动脉夹层破裂,1例死于术后消化道大出血。6例未接受外科治疗者均死于主动脉夹层破裂。结论早期识别主动脉夹层的高危患者,及时确诊、治疗,可显著减少术后并发症,降低院内病死率。
목적탐토주동맥협층사망환자적림상특점,이강저원내병사솔。방법대2004년10월-2013년10월경영상학검사학진위주동맥협층차재주원기간사망적16례림상자료진행회고분석。결과16례주동맥협층림상표현다양,여극렬적심전구동통、흉배부동통、심계、별기、대한、훈궐등,기중이시렬양흉배부동통다견。본조7례접수외과수술치료,기중1례술중사망,여6례사우술후병발증(감염、소화도대출혈、다장기공능쇠갈등)。3례행강주동맥복막지가식입술,기중2례사우주동맥협층파렬,1례사우술후소화도대출혈。6례미접수외과치료자균사우주동맥협층파렬。결론조기식별주동맥협층적고위환자,급시학진、치료,가현저감소술후병발증,강저원내병사솔。
Objective To explore the clinical characteristics of death cases of aortic dissection in order to reduce fa-tality rate. Methods Clinical data of 16 death cases of aortic dissection confirmed by the iconography examination and died during the hospital stay during October 2008 and October 2013 was retrospectively analyzed. Results The symptoms of the 16 death cases of aortic dissection were diverse such as the severe precordialgia, dorsal part of chest pain, palpitation, breathless-ness, severe sweating and syncope, in which tearing-like dorsal part of chest pain was the most common. Seven patients un-derwent surgeries, and one died during the operation, 6 patients died of postoperative complications ( infection, massive hem-orrhage of gastrointestinal tract, multiple organ failure, etc) . Three patients received descending aorta of endovascular stent-graft treatment, during which two died of aortic dissection rupture, and one died of postoperative massive hemorrhage of gastro-intestinal tract. Six cases did not undergo surgeries and died of aortic dissection rupture. Conclusion The incidence rates of postoperative complications and fatality rate in hospitals can be reduced by identifying high risk patients with aortic dissection, diagnosis and treatment as early as possible.