CAJ | 학술논문

目的：探讨主动脉夹层（ aortic dissection, AD)的诊治措施、误诊原因及防范措施。方法回顾性分析曾误诊的累及腹腔干的AD 1例的临床资料,并复习相关文献。结果患者因突发持续剧烈腹痛6 h入院,发病后在当地医院就诊,按急性胰腺炎治疗无效。入我院后经胸腹部螺旋CT动脉造影（ CTA)检查确诊为AD。于全身麻醉下行腔内支架修复术,术中造影检查明确夹层累及腹腔干。术后7 d患者恢复良好出院,随访1年预后良好。结论 AD临床表现不典型,易误诊。提高对AD的认识、深入学习其诊断要点、发散诊断思维,并及时完善相关影像学检查,可减少或避免AD误诊误治。
목적：탐토주동맥협층（ aortic dissection, AD)적진치조시、오진원인급방범조시。방법회고성분석증오진적루급복강간적AD 1례적림상자료,병복습상관문헌。결과환자인돌발지속극렬복통6 h입원,발병후재당지의원취진,안급성이선염치료무효。입아원후경흉복부라선CT동맥조영（ CTA)검사학진위AD。우전신마취하행강내지가수복술,술중조영검사명학협층루급복강간。술후7 d환자회복량호출원,수방1년예후량호。결론 AD림상표현불전형,역오진。제고대AD적인식、심입학습기진단요점、발산진단사유,병급시완선상관영상학검사,가감소혹피면AD오진오치。
Objective To study the diagnosis and treatment measures, misdiagnosis cause and preventive measures of aortic dissection. Methods Clinical data of one patient misdiagnosed with aortic dissection was retrospectively analyzed, and related literature was reviewed. Results A patient suffering from severe abdominal pain 6 for hours was admitted to our hospi-tal from a local hospital, where he had been misdiagnosed as acute pancreatitis and failed to respond to treatment there. The patient was confirmed as having acute aortic dissection by aortic computer tomography angiography. Under general anesthesia, the patient underwent thoracic endovascular aortic repair ( TEVAR) , and the celiac trunk dissection was confirmed. This pa-tient fully recovered after TEVAR, and was discharged from hospital seven days later. He was followed up for one year with good prognosis. Conclusion Atypical clinical performance of aortic dissection may be the cause of misdiagnosis. To avoid or reduce misdiagnosis and mistreatment, clinicians should enhance awareness of aortic dissection, carry out intensive research of the main points of diagnosis with the help of imagining examination.