摘要
目的 分析总结主动脉壁内血肿的临床特点、诊断、治疗和中期随访结果.方法 回顾性分析从2009年1月至2012年10月我院160例经多排增强CT确诊的主动脉壁内血肿的临床资料,并进行随访.结果 160例主动脉壁内血肿患者,男性96例,女性64例,平均年龄（59.9±9）岁；136例（85％）有高血压病史,154例（96.3％）有急性胸背痛.全部病例均行多排增强CT发现异常征象,其中Stanford A型35例、Stanford B型124例.101例行内科药物治疗,53例行主动脉腔内覆膜支架术,6例Stanford A型行外科手术治疗.共随访148例,平均随访时间（10.26±6.32）个月,死亡4例,3例为Stanford A型,1例为Stanford B型,均为药物治疗患者,行主动脉腔内覆膜支架术及外科手术的患者均恢复满意.结论 多排增强CT可确诊主动脉壁内血肿,提高该病的早期诊断,并有助于选择合适的治疗方法,改善预后.对于Stanford A型患者,外科手术治疗可降低死亡率,对大多数B型主动脉壁内血肿患者,药物治疗效果好,介入覆膜支架对有破裂风险的高危患者临床效果满意.
Objective To analyze the clinical characteristics,diagnosis and treatment of patients with aortic intramural hematoma（AIH） and their mid-term follow-up results. Methods Atotal of 160 consecutive patients with AIH from January 2009 to October 2012 admitted in our hospital were retrospectively summa- rized.There were 96 male and 64 female weith the mean age of 59.9＋9.0 years. The diagnosis was confirmed by electron beam tomography 64 detector enhanced spiral CT in each patient,and the follow-up study was carried out for 10.26＋6.32 months. Results There were 136（85%.0）patients with history of hypeitension,154 （96.3%） suffered from the acute chest pain and back pain.35 patients were diagnosed for Stanford type A AIH and 124 for Stanford type B AIH.All patients were treated with anti-hypertension,and 53 with type B received endovascular stented graft repair.,and 6 with typeA received surgical operation,136 patients finished the fonow-up study, of them 3 with type A and one with type B died,they were all received conservative medication.130 patients had satisfied recovery. 53 with the endovascular stented graft repair and 6 with the surgical operation were in good condition as wen. Conclusion 64 detector enhanced spiral CT examination would improve the early diagnosis pf aortic intramural hematoma and therefore improve the treatment and prognosis.Most of Stanford type B aortic dissection could be stabilized with the advanced medication.En- dowascular stented graft repair could help the patient with the high risk of rupture potentials and reduce the short and mid-term mortality.
出处
《中国心血管病研究》
CAS
2013年第10期781-783,共3页
Chinese Journal of Cardiovascular Research
关键词
壁内血肿
诊断
治疗
主动脉腔内修复术
随访
预后
Intramural hematoma
Diagnosis
Treatment
Endovascular repair
Follow-up
Prognosis
