目的　探讨主动脉夹层的临床表现 ,急诊诊断及误诊情况。方法　分析 5 3例主动脉夹层临床表现、体格检查、实验室检查及心电图、X线片、CT、B超等辅助检查结果 ,分析急诊诊断的依据及急诊误诊情况。结果　 5 3例主动脉夹层临床表现各异 ,部份病例以并发症为首发症状 ,如瘤体破裂造成的急性心脏压塞征、出血性休克 ,亦有主动脉分枝急性闭塞造成器官缺血坏死或压迫所致的单瘫、截瘫、急性左心衰、气胸、中等量以上心包积液 ,是造成本组误诊的主要原因。主动脉夹层系一少见疾病 ,临床医师缺乏对本病的认识也是原因之一。初诊误诊率 2 8%。结论　主动脉夹层临床表现复杂 ,易误诊 ,应引起急诊工作者的重视 Objective To investigate the clinical manifestations, emergency diagnosis and misdiagnosis of aortic dissection. Methods The clinical manifestations, physical examination, laboratory tests and electrocardiogram, X-ray, CT, B-ultrasound and other auxiliary findings of 53 aortic dissections were analyzed. The basis of emergency diagnosis and emergency misdiagnosis were analyzed. Results The clinical manifestations of 53 cases of aortic dissection were different. In some cases, complications were the first symptom, such as acute cardiac blockade caused by rupture of the tumor, hemorrhagic shock, acute ischemia of the aorta branch, and organ ischemia Paralysis caused by necrosis or oppression, paraplegia, acute left heart failure, pneumothorax, moderate amount of pericardial effusion, is the main reason for misdiagnosis in this group. Aortic dissection is a rare disease, clinicians lack awareness of the disease is also one of the reasons. Misdiagnosis rate of the first visit 28%. Conclusions The clinical manifestations of aortic dissection are complex and easily misdiagnosed, which should be paid more attention to by emergency workers