CAJ | 학술논문

目的探讨急性主动脉夹层(AAD)的临床特点.方法收集36例AAD患者的临床资料,包括性别、年龄、临床表现、实验室以及辅助检查、治疗以及预后等.结果本研究男22例,女14例,年龄43～73岁.36例患者均有不同程度的疼痛,部分患者伴有晕厥、心悸、咯血、胸腔积液、中上腹搏动性包块及血管杂音、血压升高.部分患者出现血白细胞升高、缺血性心电图改变、主动脉增宽、主动脉真假腔.确诊后均给予降压、镇静、止痛等治疗.13例病情稳定后出院；13例转往上级医院,其中2例死亡,9例行血管内支架手术治疗,2例行手术治疗；9例在确诊后的12～24 h内死亡；1例放弃治疗.结论 AAD以胸痛为主要临床表现,辅助检查发现主动脉真假腔可确定诊断.医生要提高对本病的认识,做到早期诊断和早期治疗,减少临床误诊率和病死率.
목적 탐토급성주동맥협층(AAD)적림상특점.방법 수집36례AAD환자적림상자료,포괄성별、년령、림상표현、실험실이급보조검사、치료이급예후등.결과 본연구남22례,녀14례,년령43～73세.36례환자균유불동정도적동통,부분환자반유훈궐、심계、각혈、흉강적액、중상복박동성포괴급혈관잡음、혈압승고.부분환자출현혈백세포승고、결혈성심전도개변、주동맥증관、주동맥진가강.학진후균급여강압、진정、지통등치료.13례병정은정후출원；13례전왕상급의원,기중2례사망,9례행혈관내지가수술치료,2례행수술치료；9례재학진후적12～24 h내사망；1례방기치료.결론 AAD이흉통위주요림상표현,보조검사발현주동맥진가강가학정진단.의생요제고대본병적인식,주도조기진단화조기치료,감소림상오진솔화병사솔.
Objective To evaluate the clinical characteristics of acute aortic dissection(AAD).Methods The clinical features of 36 cases of AAD were collected including age,gender,clinical manifestation,laboratory and auxiliary examination,therapeutics and prognosis.Results There were 22male cases,and 14 female cases,age 43-73 years old.All cases had different degree ache,and some cases accompanied with syncope,palpitation,hemoptysis,hydrothorax,meso-superior belly pulsate lump and vascular murmur,elevated blood pressure.Some cases appeared elevated leukocytes,ischemic electrocardiogram,broadened aorta,real and pseudocoele.All cases were given decompression,appeasement,analgesia and so on.Thirteen cases discharged from hospital after stabilized pathogenetic condition;13 cases transfered upto higher level hospital,and 2 cases died,9 cases were given endovascular stent,2cases were given surgery;9 cases died within 12-24 h after final diagnosis; 1 case abandoned therapy.Conclusions The thoracalgia is the main clinical manifestation of AAD,and diagnosis may be determined if auxiliary examination detects aorta real and pseudocoele.Physician should improve the realization of AAD,to reach early diagnosis and treatment,to decrease the rate of clinical misdiagnosis and death from illness.