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妊娠合并主动脉夹层的诊断和治疗现状

     

摘要

Pregnancy with aortic dissection is very dangerous,featured with rapid progression,and easy misdiagnosis,which leads to extremely high maternal mortality.It closely relates to diseases like hypertension,but also has some connection with the unique characteristics of the pregnant women themselves,and even some genetic diseases.Diagnosis mainly comes from the comprehensive judgments with clinical manifestations,such as the suddenly severe and persistent chest pain,and ultrasonographic examination.The current treatments generally include supportive care,drug treatment,surgical treatment,mainly based on the scope and type of the aortic dissection,as well as gestational age and expectations of the patients and families,however,the psychological counseling for the pregnant women should not be ignored.Tertiary prevention and multi-disciplinary treatment can help to achieve a better outcome both for the maternal and neonatal.%妊娠合并主动脉夹层病情凶险,并且发展迅速,极易误诊,母婴病死率极高,该病病因与高血压等疾病相关,但是也有妊娠妇女自身的独特性,甚至与某些先天性遗传性疾病相关.诊断主要从突发剧烈而持续的胸痛等特征性临床表现以及B超等辅助检查综合判断.目前治疗以一般支持治疗、药物治疗、手术治疗等为主,主要依据主动脉夹层累及的范围与类型、胎儿孕周、患者及家属期望值综合决定,但不应忽视对孕妇的心理疏导,三级预防及多学科综合治疗可获得较好的母婴结局.

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