论文部分内容阅读
临床资料例1:患者女性,38岁,突发腹部剧烈疼痛,伴恶心、呕吐1.5 h入院。疼痛向腰骶部放射,入院后呕吐5次,均为胃内容物。查体:BP 175/110 mmHg,P 82次/min,急性痛苦病容,双肺呼吸音清,主动脉Ⅰ、Ⅱ听诊区可闻及3级舒张期吹风样杂音,腹肌紧张,肝脾未触及,右肾区有叩击痛,询问月经史无异常,继往无痛经史。腹透:右上腹可见少许胀气,未见液气平及膈下游离气体,血淀粉酚75 u/L,初步诊断为右肾结石。急查妇科、泌尿系统 B 超,未见明显异常。但提示腹主动脉条索状回声及真假双腔。急查 MRI,提示:腹主动脉增宽,可见真假双腔,诊断为主动脉夹层动脉瘤 B 型,转入心脏外科治疗。
Clinical data Example 1: Female patient, 38 years old, sudden severe abdominal pain, with nausea, vomiting 1.5 h admission. Radiation to the lumbosacral pain, vomiting 5 times after admission, are stomach contents. Examination: BP 175/110 mmHg, P 82 times / min, acute pain, lung breath sounds clear, aortic Ⅰ, Ⅱ can be heard and three diastolic hair-like murmur, abdominal muscle tension, liver and spleen not Touch, the right kidney area percussion pain, asking no abnormal menstruation history, the past painless history. Peritoneal dialysis: a little flatulence can be seen on the right upper quadrant, no gas level and free gas under the diaphragm, blood urea 75 u / L, a preliminary diagnosis of right kidney stones. Urgent investigation gynecological urinary system B, no obvious abnormalities. But prompted abdominal aortic cord echo and true double chamber. Emergency MRI, suggesting: widening of the abdominal aorta, showing true and false double lumen, diagnosis of aortic dissection type B, into the heart surgical treatment.