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目的分析主动脉夹层的临床及病理特点。方法回顾性分析1998年1月-2011年10月26例主动脉夹层致死的临床及法医尸检病理资料,对其发病、死亡经过、诊断、死因进行总结。结果 26例主动脉夹层平均发病年龄为39.2岁,男女比例为3.3︰1;26例中6例无临床诊断,17例误诊,3例疑似诊断。26例主动脉夹层中,夹层破裂致心包填塞死亡20例,夹层破裂致失血性休克死亡5例,主动脉夹层未破裂1例系心衰致死;26例按DeBakey分类标准9例为Ⅰ型,14例为Ⅱ型,3例为Ⅲ型。结论临床应警惕主动脉夹层的特殊临床表现并采取必要的辅助检查,有助于主动脉夹层的诊治和减少医疗纠纷的发生。
Objective To analyze the clinical and pathological features of aortic dissection. Methods From January 1998 to October 2011, 26 cases of aortic dissection and clinical autopsy pathology were retrospectively analyzed. The incidence, death, diagnosis and cause of death were summarized. Results The average age of onset of aortic dissection in 26 cases was 39.2 years. The ratio of male to female was 3.3︰1. Six of 26 cases had no clinical diagnosis, 17 cases were misdiagnosed and 3 cases had suspected diagnosis. 26 cases of aortic dissection, 20 cases of cardiac catheterization caused by dissection rupture, 5 cases died of dissection rupture caused by hemorrhagic shock, 1 case of aortic dissection did not rupture and died of heart failure; 26 cases according to DeBakey classification criteria for 9 cases of type Ⅰ, 14 cases were type Ⅱ and 3 cases were type Ⅲ. Conclusion Clinical should be alert to the special clinical manifestations of aortic dissection and take the necessary auxiliary examination, is helpful for the diagnosis and treatment of aortic dissection and reduce the occurrence of medical disputes.