主动脉夹层64例临床诊断及误诊分析  

Analysis of clinical diagnosis and misdiagnosis of 64 patients with aortic dissection

作　　者：蔡远翔[1,2] 李伟明[2] 徐亚伟[2] 李沅敏[2] 

机构地区：[1]同济大学医学院,上海200092 [2]同济大学附属第十人民医院心内科,上海200072

出　　处：《临床肺科杂志》2013年第3期439-441,共3页Journal of Clinical Pulmonary Medicine

基　　金：上海市科委重大课题研究资助项目(05DZ19503)

摘　　要：目的探讨主动脉夹层的临床表现、临床诊断及误诊情况。方法收集诊断为AD的64例患者的临床资料,分析其临床特点、影像学诊断及误诊情况。结果①突发胸、腹部剧烈、持续疼痛是本病的主要临床表现。②影像学MSCTA检查是确诊本病的最佳方法。③误诊疾病复杂多样,以冠心病和急腹症居多,首诊误诊率为12.5%。结论主动脉夹层首发症状主要为持续剧烈胸腹疼痛,早期诊断是治疗关键,MSCTA检查有助于确诊,同时AD的误诊率高,误诊的疾病种类繁多,应引起临床医师的高度重视。Objective To study the clinical features, diagnosis and misdiagnosis of patients with aortic dissection （AD）. Meth- ods The clinical data of 64 patients with AD were collected to analyze the clinical features, diagnosis and misdiagnosis. Results The severe and accidental chest or abdominal ache was the main clinical manifestation. MSCTA imaging was the best diagnostic method. The most easy misdiagnosed diseases were coronary heart disease and acute abdomen, and the first misdiagnosis rate was 12. 5%. Conclusion The first symptoms is continuous acute chest or abdominal pain is original manifestation of AD, and the key point is to give early diagno- sis and timely treatment. Because the aortic dissection is very easy to be misdiagnosed as many other diseases, it should be paid more at- tention by clinicians.

关 键 词：主动脉夹层 诊断 误诊 

分 类 号：R543.1[医药卫生—心血管疾病]