主动脉夹层临床特点及误诊原因分析  

The clinical characteristics and misdiagnosis reason analysis of aortic dissection

作　　者：张郁林[1] 周波[1] 杨卫东[1] 张立伟[1] 

机构地区：[1]湖北省宜昌市第一人民医院心胸血管外科,443000

出　　处：《中国实用医刊》2013年第15期42-43,共2页Chinese Journal of Practical Medicine

摘　　要：目的进一步了解主动脉夹层的临床特点，分析误诊原因。方法回顾分析宜昌市第一人民医院收治的15例主动脉夹层误诊患者的临床资料。结果本组1例初诊为下肢动脉血栓栓塞、2例胆囊炎、1例急性胰腺炎、5例冠心病、2例低钾麻痹、2例心包积液，2例胸膜炎。所有患者经心脏彩超和（或）胸腹部CT检查时疑似主动脉夹层，进一步行CTA主动脉增强检查明确诊断。结论因主动脉夹层的病变部位及累及范围不同，其临床表现各异，首诊易误诊、漏诊。临床医师应对其临床特点有清楚的认识并保持高度警惕，尽量减少或避免误诊，以及时进行救治。Objective To further understand the clinical characteristics of aortic dissection, and analyze the misdiagnosis reasons. Methods A retrospective analysis was made of the clinical materials of 15 cases of aortic dissection misdiagnosed. Results One case was misdiagnosed as lower limb arterial thromboembolism, 2 cases as cholecystitis, 1 case as acute pancreatitis, 5 cases as coronary heart dis- ease, 2 cases as periodic paralysis, 2 cases as pericardial effusion, 2 cases as pleurisy. All cases were examined by echocardiography and （or） chest-abdomen CT, when suspected aortic dissection, further examined by CTA to diagnosis. Conclusions Because the lesion site and the range of aortic dissection was different, its clinical manifestations were different, so the first diagnosis easy to misdiagnosis and miss diagnosis. The physicians must to have a clear understanding and maintain vigilance to its clinical characteristics, so that reduce or avoid misdiagnosis as soon as possible and treat timely.

关 键 词：主动脉夹层 临床特点 误诊 分析 

分 类 号：R543.1[医药卫生—心血管疾病]