主动脉夹层37例临床分析  

A clinical analysis of 37 patients with aortic dissection

作　　者：卜彤[1] 曾昭华[1] 张海军[1] 罗福全[1] 潘秀娣[1] 

机构地区：[1]广州医学院第一附属医院心内科,510120

出　　处：《国际医药卫生导报》2013年第7期946-950,共5页International Medicine and Health Guidance News

摘　　要：目的探讨主动脉夹层（aorticdissection，AD）患者的临床特征及影响预后的若干因素。方法回顾收集2007年1月至2009年12月广州医学院第一附属医院住院确诊为AD病人37例（男31例，女6例），统计分析其的易患因素，A型、B型AD的特点及不同处理方式对预后的影响。结果AD病人男性占83．7％，高血压占78．4％，大量吸烟占62．2％。AD病人总死亡率为16．2％，A型死亡率为25．0％，B型死亡率5．9％。除A型AD介入治疗死亡率明显增高外；其余内科保守治疗，外科主动脉置换术，B型AD介入治疗三种处理方式比较显示对死亡率影响未见明显区别。结论高血压病、大量吸烟、男性是AD的主要易患因素；AD病死率高，尤以A型为甚；主动脉腔内隔绝术（介入治疗）不宜用于A型AD，是B型AD有效的治疗方法；目前有效的内科治疗仍是AD治疗的基础。Objective To explore the clinical featuers in patients with aortic dissection （AD） and the factors affecting the prognosis of the disease. Methods The data on 37 patients （31males and 6 females） with AD who had been hospitalized from January 2007 to December 2009 were retrospectively collected. The risk factors, characteristics of types A and B, and effects of different therapies on the prognosis were analyzed. Results Of the patients with AD, 83.7% were male, 78.4% had hypertension, and 62.2% were heavy smokers. The total mortality rate was 16.2%; and the mortality rate was 25% for type A and 5.9% for type B. The mortality rate significantly increased in type A patients undergoing endovascular repair procedure and it did not differ significantly among the patients receiving medical therapyor surgical aortic replacement, or those with type B undgoing endovascular repair procedure. Conclusions Hypertension, heavy smoking, and male are the main risk factors for AD. AD has a higher mortality rate, especially for type A. Endovascular exclusion （endovascular repair procedure） is not recommended as a treatment for type A; however, it is an effective procedure for type B. Medical therapy is still the fundamental treatment for both types of AD.

关 键 词：主动脉夹层 高血压 腔内隔绝术 

分 类 号：R543.1[医药卫生—心血管疾病]