82例急性主动脉夹层的临床特征分析
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摘要
<正>急性主动脉夹层(acute aortic dissection,AAD)是指急性的主动脉的内膜和中层弹力膜撕裂,导致高压血流经破裂的内膜口冲入血管壁中层顺行或逆行剥离,并通过一个或数个破口与主动脉真假腔相交通。英国的一项前瞻性研究报道AAD每年约6/10万的发病率~([1]);未经治疗的患者出现症状后,其致死率每小时增加1%～2%~([2]),它是一种少见但危及生命的心血管急危重症。以前人们对该病认识不足导致误诊漏诊,死亡率高,现在对其警惕性增加,
引文
[1] Howard DP,Banerjee A,Fairhead JF,et al.Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control:10-year results from the Oxford Vascular Study[J].Circulation,2013,127(20):2031-2037.
[2] Gawinecka J,Sch?nrath F,von Eckardstein A.Acute aortic dissection:pathogenesis,risk factors and diagnosis[J].Swiss Med Wkly,2017,147:w14489.
[3] 孙立忠,朱俊明,刘永民,等.主动脉夹层诊断与治疗规范中国专家共识[J].中华胸心血管外科杂志,2017,33(11):641-654.
[4] 邓娟,王芳,黄素芳,等.我国主动脉夹层患者死亡危险因素研究的文献计量学分析[J].临床急诊杂志,2017,18(6):452-456.
[5] 闫圣涛,张国虹,练睿,等.162例急性主动脉夹层临床分析[J].中华急诊医学杂志,2015,24(7):729-734.
[6] Wang W,Duan W,Xue Y,et al.Clinical features of acute aortic dissection from the Registry of Aortic Dissection in China[J].J Thorac Cardiovasc Surg,2014,148(6):2995-3000.
[7] 罗常有,王善花,陈本发,等.急性主动脉夹层168例临床诊治分析[J].临床误诊误治,2018,31(2):1-5.
[8] 袁祖贻.不忘初心,方得始终:大数据分析西北地区慢性病防控[J].临床心血管病杂志,2018,34(8):739-742.
[9] 李杨,刘思奇,段维勋,等.急性主动脉夹层临床特征的分析[J].中国循证心血管医学杂志,2013,5(6):588-592,614.
[10] 黄素芳,陈园园.无痛性主动脉夹层的临床分析[J].临床急诊杂志,2016,17(7):560-563.
[11] 张剑,贺行巍,邱云.以声音嘶哑伴咳嗽为首发表现的无痛性主动脉夹层1例[J].临床急诊杂志,2017,18(6):476-477.
[12] 薛凌,罗建方,罗淞元,等.高血压合并主动脉夹层患者血压控制状况分析[J].中华高血压杂志,2012,20(11):1039-1042.
[13] 陈永辉.吗啡、硝普钠及美托洛尔联合治疗急性主动脉夹层的疗效观察[J].临床合理用药杂志,2019,12(1):65-66.
[14] 迪里夏提·斯提,马翔.急性主动脉夹层中疼痛控制现状与进展[J].心血管病学进展,2016,37(6):607-610.
[15] Fukui T.Management of acute aortic dissection and thoracic aortic rupture[J].J Intensive Care,2018,6:15.
[16] 吴怡锦,熊卫萍,曾嵘,等.孙氏手术治疗急、慢性Stanford A型主动脉夹层疗效的病例对照研究[J].中国胸心血管外科临床杂志,2018,25(5):401-405.
[17] Erbel R,Aboyans V,Boileau C,et al.2014 ESC Guidelines on the diagnosis and treatment of aortic diseases:Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult.The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology(ESC)[J].Eur Heart J,2014,35(41):2873-2926.
[18] 苏存华,谈梦伟,陆方林,等.268例急性A型主动脉夹层临床资料分析[J].国际心血管病杂志,2013,40(3):189-191.
[19] Li D,Ye L,Yu J,et al.Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection[J].Oncotarget,2017,8(45):79315-79322.
[2] Gawinecka J,Sch?nrath F,von Eckardstein A.Acute aortic dissection:pathogenesis,risk factors and diagnosis[J].Swiss Med Wkly,2017,147:w14489.
[3] 孙立忠,朱俊明,刘永民,等.主动脉夹层诊断与治疗规范中国专家共识[J].中华胸心血管外科杂志,2017,33(11):641-654.
[4] 邓娟,王芳,黄素芳,等.我国主动脉夹层患者死亡危险因素研究的文献计量学分析[J].临床急诊杂志,2017,18(6):452-456.
[5] 闫圣涛,张国虹,练睿,等.162例急性主动脉夹层临床分析[J].中华急诊医学杂志,2015,24(7):729-734.
[6] Wang W,Duan W,Xue Y,et al.Clinical features of acute aortic dissection from the Registry of Aortic Dissection in China[J].J Thorac Cardiovasc Surg,2014,148(6):2995-3000.
[7] 罗常有,王善花,陈本发,等.急性主动脉夹层168例临床诊治分析[J].临床误诊误治,2018,31(2):1-5.
[8] 袁祖贻.不忘初心,方得始终:大数据分析西北地区慢性病防控[J].临床心血管病杂志,2018,34(8):739-742.
[9] 李杨,刘思奇,段维勋,等.急性主动脉夹层临床特征的分析[J].中国循证心血管医学杂志,2013,5(6):588-592,614.
[10] 黄素芳,陈园园.无痛性主动脉夹层的临床分析[J].临床急诊杂志,2016,17(7):560-563.
[11] 张剑,贺行巍,邱云.以声音嘶哑伴咳嗽为首发表现的无痛性主动脉夹层1例[J].临床急诊杂志,2017,18(6):476-477.
[12] 薛凌,罗建方,罗淞元,等.高血压合并主动脉夹层患者血压控制状况分析[J].中华高血压杂志,2012,20(11):1039-1042.
[13] 陈永辉.吗啡、硝普钠及美托洛尔联合治疗急性主动脉夹层的疗效观察[J].临床合理用药杂志,2019,12(1):65-66.
[14] 迪里夏提·斯提,马翔.急性主动脉夹层中疼痛控制现状与进展[J].心血管病学进展,2016,37(6):607-610.
[15] Fukui T.Management of acute aortic dissection and thoracic aortic rupture[J].J Intensive Care,2018,6:15.
[16] 吴怡锦,熊卫萍,曾嵘,等.孙氏手术治疗急、慢性Stanford A型主动脉夹层疗效的病例对照研究[J].中国胸心血管外科临床杂志,2018,25(5):401-405.
[17] Erbel R,Aboyans V,Boileau C,et al.2014 ESC Guidelines on the diagnosis and treatment of aortic diseases:Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult.The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology(ESC)[J].Eur Heart J,2014,35(41):2873-2926.
[18] 苏存华,谈梦伟,陆方林,等.268例急性A型主动脉夹层临床资料分析[J].国际心血管病杂志,2013,40(3):189-191.
[19] Li D,Ye L,Yu J,et al.Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection[J].Oncotarget,2017,8(45):79315-79322.