摘要
目的:通过分析比较急诊就诊Standford A型与B型主动脉夹层的一般特点、临床表现、治疗及预后,为临床快速识别、诊断及治疗主动脉夹层提供依据,以期缩短滞留时间,及时有效治疗,减少患者病死率。方法:采用回顾性研究方法纳入2018年10月-2021年01月期间我院急诊首诊并明确诊断为主动脉夹层的患者43例。对入组患者人口统计学资料、临床表现、辅助检查、治疗方案及预后情况进行统计学分析。结果:A型患者平均发病年龄为(49.96±15.30)岁,B型患者平均发病年龄为(64.39±13.62)岁,A型患者发病年龄比B型明显年轻化(t=-3.19,P=0.003),且A型发病时间更短(U=476.50,P=0.046)。在患者尚未完善影像学检查时,ADD-RS评分联合D-二聚体诊断主动脉夹层具有较高的预测价值。手术是有效治疗方法,及时行手术治疗患者生存率明显升高(χ^(2)=16.32,P<0.001)。结论:急诊就诊患者中,A型主动脉夹层患者发病年龄相较于B型更趋于年轻化,发病急进性和临床表现更明显。ADD-RS评分联合D-二聚体检测可有效预测主动脉夹层,诊断为主动脉夹层后,及时行手术治疗能显著提高患者的存活率。
Objective:Analyze the general characteristics of aortic dissection in different types of aortic dissection,perform diagnostic analysis,evaluate postoperative survival rate,provide a method for diagnose and treatment,and use it to determine the condition of the disease in a timely and accurate manner accurately to reduce mortality.Methods:We enrolled 43 patients diagnosed with AD from Oct 2018 to Jan 2021 in the Emergency Department of our hospital.All of their demographic data,laboratory tests,and clinical data of all patients were collected and analyzed.Results:The average age of type A patients was(49.96±15.30)years old,and the average age of type B patients was(64.39±13.62)years old.The difference was statistically significant(t=-3.19,P=0.003).Type A patients exhibited a shorter onset time than type B patients(U=476.50,P=0.046).ADD-RS combined with D-dimer is a fast and exact method to diagnose AAD before a patient undergoes imaging assessments.The survival rate of both types of patients increased significantly after surgery(χ^(2)=16.32,P<0.001),and postoperative deaths accounted for 5.7%.Conclusion:The age suffered type A AD is younger when compared with type B,and the clinical symptoms are more obvious.Type A has a higher clinical mortality rate,and emergency surgery is an effective treatment to cure patients.When the ADD-RS score>1 and D-dimer level is greater than 0.5 mg/L,AD is highly suspected.Surgery is an effective and key method for the treatment of aortic dissection,which can significantly improve the survival rate of patients.
作者
张陈光
张向阳
王琰
段敏
王科
宋开元
孔冰冰
陈妤
陈旭岩
ZHANG Chenguang;ZHANG Xiangyang;WANG Yan;DUAN Min;SONG Kaiyuan;WANG Ke;KONG Bingbing;CHEN Yu;CHEN Xuyan(Department of Emergency,Beijing Tsinghua Changgeng Hospital,School of Clinical Medicine,Tsinghua University,Beijing,102218,China)
出处
《临床急诊杂志》
CAS
2021年第11期747-751,共5页
Journal of Clinical Emergency
