摘要
主动脉夹层是由于各种原因导致的主动脉内膜、中膜撕裂,主动脉内膜与中膜分离,血液流入,致使主动脉腔被分割为真腔和假腔。主动脉夹层是死亡风险最高的心血管急症之一,若前48 h内未行手术治疗,其病死率高达50%。近年来随着诊断及外科手术技术的进步,主动脉夹层病死率显著下降。随着生存率的提高,相关研究发现患者预后与夹层术后并发症密切相关,术后并发症严重影响患者术后康复并降低其术后生活质量。神经系统并发症,尤其是缺血性脑卒中、脊髓缺血,是主动脉夹层术后最常见、最严重的并发症,如何预防术后神经系统并发症并降低其发生率已成为目前的研究热点,如何诊断与治疗术后神经系统并发症也受到神经科医师的广泛关注。本文报道2例主动脉夹层术后并发神经系统并发症患者的诊疗过程,并结合文献进行学习,以提高神经科医师对主动脉夹层术后并发神经系统并发症的警惕性与关注度。
Aortic dissection is the tearing of the intima and media of the aorta due to various causes.The intima of the aorta is separated from the media and then blood flows in,resulting in the division of the aortic lumen into true lumen and false lumen.Aortic dissection is one of the cardiovascular emergencies with the highest mortality risk,and the mortality rate is as high as 50%if no surgical treatment is performed within the first 48 hours.In recent years,with the progress of diagnosis and surgical techniques,the case fatality rate of aortic dissection has decreased significantly.With the improvement of survival rate,relevant studies have found that patients'prognosis is closely related to postoperative complications of dissection,which seriously affect patients'postoperative rehabilitation and reduce patients'postoperative quality of life.Neurological complications,especially ischemic stroke and spinal cord ischemia,are among the most common and severe postoperative complications of aortic dissection.How to prevent and reduce the incidence of postoperative neurological complications has become a hot research topic at present.How to diagnose and treat postoperative neurological complications has also attracted extensive attention from neurologists.In this article,we reported the diagnosis and treatment process of two patients with postoperative neurological complications of aortic dissection and reviewed the literature,to improve the vigilance and attention of neurologists on the postoperative neurological complications of aortic dissection.
作者
李安
张秀萍
白波
赵阳
薛国芳
李东芳
An Li;Xiuping Zhang;Bo Bai;Yang Zhao;Guofang Xue;Dongfang Li(Department of Neurology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中华脑血管病杂志（电子版）》
2023年第4期373-378,共6页
Chinese Journal of Cerebrovascular Diseases(Electronic Edition)
基金
石药集团中国原创药物研究基金项目(YXSY-2020-40)。
关键词
主动脉夹层
并发症
神经系统
脑梗死
脊髓缺血
Aortic dissection
Complications
Neurological
Cerebral infarction
Spinal cord ischemia
