目的：探讨主动脉夹层的临床特点及诊治方法。方法：对本科收治的62例主动脉夹层患者的病因和诱因、临床表现、辅助检查结果、诊断分型、治疗方式及效果进行回顾性分析。结果：62例主动脉夹层中，Stanford A型18例，Stanford B型44例，高血压是该病最主要的高危因素，多数以胸背部疼痛为首要症状，主动脉增强CT及三维重建有助于明确诊断。本组中15例行外科手术治疗，术后死亡2例（13.3%），截瘫1例（6.7%）；41例行覆膜支架人工血管腔内隔绝术，术后发生内瘘2例（4.9%），死亡1例（2.4%），截瘫1例（2.4%）。术前死亡4例（6.4%），自动出院2例（3.2%）。其余随访患者术后未出现与主动脉夹层及手术相关的并发症，总体生存质量好。结论：早期诊断并及时合理的治疗是改善主动脉夹层患者预后的关键。%Objective:To investigate the clinical character ,diagnosis and treatment of aortic dissection.Method:Clinical data of the pathogeny,inducement, clinical manifestation,accessory examination,diagnostic classification,treatment methods and effect of 62 patients with aortic dissection were retrospectively analyzed. Result:Stanford type A in 18 cases,Stanford type B in 44 cases.Hypertension was the main high risk factor,the first symptom for most of patients was the Chest and back pain.Enhanced spiral CT scans and three dimensional reconstruction of aorta were benefit to diagnose definitely.Among 15 cases proceeded with cardiothoracic surgical treatment,2 cases (13.3%) died and one case(6.7%) happened paraplegia.41 cases were performed endoluminal stent-graft implantation, and 2 cases(4.9%) occurred endoleak,one case(2.4%) died and one case(2.4%) happened paraplegia.4 cases (6.4%) died of before operation,2 cases(3.2%) auto-discharged.By Follow-up the remaining patients ,we found that no one appeared the related complications of aortic dissection or operations and owned a good total life quality. Conclusion:Early diagnosis and reasonable treatment in time are the key to improve the prognosis of patients with aortic dissection.
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