主动脉夹层累及范围与患者症状关系的临床分析

目的　探讨主动脉夹层患者首发及伴随症状与夹层分离解剖范围的关系。方法　对1991～ 2 0 0 3年就诊的 2 0 7例主动脉夹层患者的起病症状、疼痛部位、放射部位进行归纳 ,并通过CT、磁共振、超声心动图等确定所有患者主动脉夹层的解剖位置与范围 ,以 χ2 分析不同临床症状间夹层所累及范围的区别。结果　对于夹层破口 ,临床症状以胸痛、牙痛、疼痛涉及头颈者夹层大多位于升主动脉 ,而肩背痛、疼痛涉及腰腹或下肢者 ,多位于降主动脉或以下 ;对于夹层终点 ,肩背痛、晕厥为首发、无症状者、疼痛涉及牙、头颈部者 ,夹层终点多在胸降主动脉以上 ;腹痛、少尿、疼痛涉及腰腹或下肢者 ,夹层终点以腹降主动脉或以下为主。结论　主动脉夹层患者的症状与分离范围存在一定联系 ,可为首诊医生初步的诊断与定位提供依据

Clinical research on symptoms and dissection range of aortic dissection patients

Objective To investigate the relationship between clinical symptoms and Dissection range of aortic dissection (AD) patients. Methods Two hundred and seven AD patients from 1991 to 2003 were collected. Symptoms, pain locus, emission locus of all patients were recorded; anatomical position and range of dissection of aorta were detected by CT, MR or UCG. The relationship between clinical symptoms and dissection range were analyzed by Chi squared test. Results The origin of aortic dissection was in ascending aorta when patients had symptoms such as chest pain, toothache, or involved in head or collum; in or below descending aorta when patients had pain involved in shoulders, dorsum, waist, abdomen or lower limb. The destination of aortic dissection was above thoracic aorta when syncope, pain involved in shoulders, dorsum, tooth, head or collum, or absence of symptoms; in or below abdominal aorta when oliguria or pain involved in abdomen or lower limb. Conclusion There have some relationships between anatomical position and range of dissection of aorta and symptoms, pain locus, emission locus of AD patients.