主动脉夹层并发心包积液100例临床分析  

Clinical analysis of 100 cases with aortic dissection complicated with pericardial effusion

作　　者：陈娟[1] 周颜慧[2] 马业新[2] 郭小梅[2] 

机构地区：[1]湖北省鄂州市优抚医院 [2]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《内科急危重症杂志》2012年第6期348-350,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨主动脉夹层(AD)并发心包积液的临床特征及治疗策略。方法:回顾性分析我院诊治的100例AD并发心包积液患者的临床资料。结果:对胸痛伴发或首发晕厥或黑矇、呼吸困难、心悸、脉压减小、主动脉瓣区杂音、胸腔积液者应考虑并发心包积液可能性。对于A型AD合并心包积液患者,好转率明显低于不合并心包积液患者(29.6%vs59.1%,P<0.05)。对于AD合并心包积液患者,药物保守治疗的好转率明显低于外科手术或支架介入治疗好转率(32.4%vs57.6%,P<0.05;32.4%vs100%,P<0.05),其病死率明显高于外科手术治疗(32.4%vs3.9%,P<0.05)。结论:对AD合并心包积液患者,不论是否出现心包压塞症状,及时早期确诊、采取积极的介入或手术治疗是降低病死率、改善预后的关键。Objective：To explore the clinical characteristics and treatment strategies of aortic dissection complicated with pericardial effusion. Methods：Clinical data of 100 patients with aortic dissection complicated with pericardial effusion were analyzed retrospectively. Results ： Patients with chest pain, along with syncope, amaurosis fugax, dyspnea, palpitation, decreased pulse pressure, murmurs over aortic valve area and pleural effusion should be considered as pexicardial effusion. For patients with aortic dissection complicated with pericardial effusion, the cure rate was lower than that without pericardial effusion （29.6% vs 59.1%, P 〈 0.05 ）. For patients with AD complicated with pericardial effusion, the cure rate of conservative treatment was significantly lower than those of surgical and interventional therapy （ 32.4% vs 57.6%, P 〈 0.05 ; 32.4% vs 100% ,P 〈 0.05）, and its mortality was higher than those of surgical treatment （ 32.4% vs 3.9% , P 〈 0.05 ）. Conclusion：Early diagnosis and treatments were crucial to reduce mortality and improve the prognosis in patients with aortic dissection complicated with pericardial effusion whether there is symptom of cardiac tamponade.

关 键 词：主动脉夹层 心包积液 诊断 治疗 

分 类 号：R543.1[医药卫生—心血管疾病]