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目的探讨主动脉夹层(AD)的病因、临床特点、诊断方法,以提高临床急诊医师对该病的认识。方法回顾性分析2006年1月-2012年12月急诊诊治28例AD患者的临床情况。结果 28例AD患者中有20例患有高血压,9例患有高血压合并冠心病,4例患有糖尿病,3例马凡氏综合征;28例AD患者以典型疼痛为首发症状20例,其余8例疼痛症状不明显;初步诊断为AD患者15例,死亡2例;延误诊断13例,死亡7例。结论 AD临床表现复杂多样,应加强对早期不典型症状的认识,通过全面细致的辅助检查及时做出正确诊断,及时治疗以降低病死率。
Objective To investigate the etiology, clinical features and diagnosis of aortic dissection (AD) in order to improve the understanding of the disease among clinical emergency physicians. Methods The clinical data of 28 patients with AD who were diagnosed and treated acutely from January 2006 to December 2012 were retrospectively analyzed. Results Twenty of 28 AD patients had hypertension, 9 had hypertension and coronary heart disease, 4 had diabetes and 3 had Marfan syndrome. Twenty patients with typical AD were treated with typical pain as the first symptom , The remaining 8 cases of pain was not obvious; initial diagnosis of AD patients in 15 cases, 2 deaths; 13 cases of delayed diagnosis and 7 deaths. Conclusion The clinical manifestations of AD are complex and diverse, and the understanding of early atypical symptoms should be strengthened. The correct diagnosis should be made timely and comprehensively in order to reduce the case fatality rate.