353例主动脉夹层中以腹泻为首发表现的临床病例分析  

Clinical features of special patients initially symptom of diarrhea in 353 cases of aortic dissection

作　　者：肖平喜[1] 戴振林[1] 胡作英[1] 张航[1] 陈绍良[1] 柳剑[2] 

机构地区：[1]南京医科大学附属南京医院,南京市第一医院心内科,江苏南京210006 [2]南京市第一医院病案室,江苏南京210006

出　　处：《热带医学杂志》2012年第12期1462-1464,共3页Journal of Tropical Medicine

基　　金：南京医科大学科学发展基金(09NJMUM075);南京市卫生局青年科技人才启动项目(QYK10143)

摘　　要：目的探讨以腹泻为首发表现的主动脉夹层患者的临床特点。方法收集主动脉夹层患者353例,寻找以腹泻症状为首发表现的临床病例,分析其发病特点及临床转归。结果仅发现3例主动脉夹层以腹泻为首发表现,该3例患者以腹泻求治急诊科,均发生不同程度、不同时间的误诊,均在住院期间死亡。3例患者的死亡原因得到确诊,其中1例因主动脉造影确诊,1例因床边超声心动图确诊,1例因尸检确诊。结论以腹泻为首发表现的主动脉夹层主诉不典型,具有较高的误诊率及院内死亡风险,临床医师应具备较高的警惕性。Objective To explore the clinical features of aortic dissection patients with the first clinical symptom of diarrhea. Methods The clinical data of 353 patients diagnosed with aortic dissection in our hospital from June 2004 to June 2011 were collected. The clinical cases with initial symptom of diarrhea were searched, and the characteristics and clinical outcomes of these cases were analyzed. Results Three cases of aortic dissection with diarrhea as their initial symptom respectively were retrieved, which all registered in emergency department at first, and were misdiagnosed as different disease in varying time. All of them were all died in hospital. The cause of death was confirmed by aortography, bedside ultrasound echocardiography and autopsy. Conclusion Such aortic dissection with the first clinical symptom of diarrhea has the clinical features of atypical chief complaints, high chance of misdiagnosis and very high risk of death and mortality. Clinical doctors should have aware of such cases.

关 键 词：主动脉夹层 腹泻 误诊 

分 类 号：R543.1[医药卫生—心血管疾病]