急性创伤性主动脉夹层临床诊治分析  

Analysis of Clinical Diagnosis and Treatment of Acute Traumatic Aortic Dissection

作　　者：刘东红[1] 王洋 何素华 翟强 周朋利[2] LIU Donghong;WANG Yang;HE Suhua;ZHAI Qiang;ZHOU Pengli(Department of Emergency Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Interventional Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Interventional Radiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Traditional Chinese Medicine,Zhoukou People’s Hospital,Zhoukou 466000,China;Department of Emergency Medicine,Zichuan District Hospital of Zibo City,Zibo 255100,China)

机构地区：[1]郑州大学第一附属医院急诊医学部,河南郑州450052 [2]郑州大学第一附属医院介入放射科,河南郑州450052 [3]河南科技大学第一附属医院介入放射科,河南洛阳471000 [4]周口市人民医院中医科,河南周口466000 [5]淄博市淄川区医院急诊内科,山东淄博255100

出　　处：《河南医学研究》2024年第23期4238-4243,共6页Henan Medical Research

摘　　要：目的总结急性创伤性主动脉夹层(TAD)的临床表现及诊治经过,探讨其早期快速诊断方法,评估患者主动脉腔内隔绝术(TEVAR)后生存质量。方法回顾性分析2015年1月至2019年12月郑州大学第一附属医院收治的14例TAD病例的临床资料,并对其预后进行欧洲五维健康量表(EQ-5D)随访调查。14例患者中1例接受Bentall+全弓置换+硬象鼻手术;13例接受TEVAR,其中1例患者术后死于急性脑出血。结果随访2~50个月,其间1例患者术后2个月死于胆囊穿孔所致的感染性休克;1例患者术后12个月死于晚期恶性肿瘤,余未见严重并发症和死亡病例。TEVAR术后10例患者接受EQ-5D随访调查,其生存质量存在不同程度的下降(P<0.05)。结论早期鉴别诊断对TAD的治疗及预后具有重要意义,TEVAR是TAD安全有效的治疗方法。术后患者因情绪影响及合并其他部位损伤,生存质量难以恢复到正常状态。Objective To summarize the clinical manifestations,diagnosis and treatment of acute traumatic aortic dissection(TAD),to explore its early and rapid diagnosis,and to evaluate the quality of life of patients after thoracic endovascular aortic repair(TEVAR).Methods The clinical data of 14 cases of traumatic aortic dissection admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2019 were retrospectively analyzed,and the prognosis was followed up by EuroQol five-dimension questionnaire(EQ-5D).Among the 14 patients,1 patient received Bentall+total arch replacement+elephant trunk surgery,13 patients received TEVAR,and one of them died of acute cerebral hemorrhage.Results During the follow-up of 2-50 months,1 patient died of septic shock caused by gallbladder perforation 2 months after operation,1 patient died of advanced malignant tumor 12 months after surgery,and no serious complications or deaths were reported.After TEVAR,10 patients received EQ-5D follow-up investigation,and their quality of life decreased to different degrees(P<0.05).Conclusion Early differential diagnosis is of great significance for the treatment and prognosis of TAD.TEVAR is a safe and effective treatment for TAD.After operation,the quality of life of patients is difficult to return to normal state due to emotional influence and other injuries.

关 键 词：创伤性主动脉夹层 主动脉腔内隔绝术 生存质量 

分 类 号：R543.1[医药卫生—心血管疾病]