摘要
目的探讨主动脉夹层的临床特征与早期诊断方法。方法回顾性收集16例主动脉夹层患者的临床表现、体格检查及辅助检查结果，分析其临床特征。结果16例主动脉夹层患者中，10例（62．5％）以突然发作的撕裂样疼痛为首发症状，12例（75．0％）出现收缩压升高，8例（50．0％）出现两侧肢体血压不对称等体征；D-二聚体、胸片、超声心动图、主动脉CT造影敏感性分别为100．0％、37．5％、75．0％、100．0％。结论突发撕裂样疼痛、收缩压升高、双侧血压不对称是急性主动脉夹层的特征性表现，并伴随D-二聚体升高。临床特征高度怀疑主动脉夹层者可将超声心动图作为初筛手段，行主动脉CT造影早期确诊，是降低病死率的关键。
Objective To investigate the clinical features of aortic dissection and the method of early diagnosis. Methods Clinical data of 16 cases of aortic dissection were collected retrospectively including clinical manifestations, physical examination and ancillary test results. Clinical features of aortic dissection were analyzed. Results In 16 patients with aortic dissection, 10 cases （62.5%） had sudden onset of tearing pain as the first symptom, 12 cases （75%） had elevated systolic blood pressure and 8 cases had presence of pulse differentials. The sensitivity of D - dimmer, chest radiography, echocardiography, CT angiography in aortic aortic dissection respectively were 100.0%, 37. 5%, 75.0%, 100.0%. Conclusion The sudden tearing pain, elevated systolic blood pressure, pulse differentials are the characteristics of acute aortic dissection accompanied by elevated D - dimmer. Based on clinical characteristics, the echocardiography can be used as primary tool of patients with suspect aortic dissection, and CT angiography is early diagnosis of aortic dissection, which is the key to reduce the mortality.
出处
《中国急救医学》
CAS
CSCD
北大核心
2013年第1期53-56,共4页
Chinese Journal of Critical Care Medicine
