急性主动脉夹层420例回顾性分析

目的:探讨湖北省随州市近10年急性主动脉夹层病例的临床特征及变化趋势。方法:收集2001年1月-2010年12月在随州市中心医院住院首次入院确诊的420例急性主动脉夹层病例进行回顾性研究。结果:急性主动脉夹层病例逐年增加。老年组心率明显低于年轻组(72.1±13.6)次/min比(83.1±17.4)次/min],年轻组的就诊时间及确诊时间明显早于老年组。女性患者确诊时间却明显迟于男性患者。Stanford A型病例发生胸痛的几率明显大于Stanford B型病例,而Stanford B型病例发生腹痛的几率明显大于Stanford A型病例。Stanford B型病例确诊时间明显迟于Stanford A型病例。急性主动脉夹层住院总死亡率为18.1%。结论:急性主动脉夹层病例逐年增多,临床工作中应高度重视胸痛、腹痛、后背痛、转移痛等症状,注意监测患者血压、心率,并高度警惕老年、女性、A型主动脉夹层的患者。

Retrospective Study of 420 Cases of Acute Aortic Dissection

Objective: To study the clinical characteristics and changing trends of acute aortic dissection(AAD) in Suizhou city of central China.Methods: The clinical data of 420 patients with AAD were collected in Central Hospital of Suizhou city from January 2001 to December 2010.The data were analyzed according to age,gender,and Stanford types.Results: The total cases of AAD increased year by year.The heart rates of old patients(>60 years) were significantly less than in the younger patients(<60 years)(72.1±13.6] beats per min vs83.1±17.4] beats per min,P<0.05).The diagnosis spent more time in old patients than in the younger patients,while the time cost was more in females vs males.Chest pain was more common in Stanford A,but abdominal pain was more common in Stanford B.The diagnosing time in Stanford B type was significantly more than in Stanford A type.In-hospital mortality of AAD was 18.1%.Conclusion: The incidence of AAD increased year by year.The pain in chest,abdomen or back,and referred pain were the main symptoms of acute aortic dissection.The changes of blood pressure and heart rate were the main signs.More attention should be paid to the old,female,or Stanford A type patients.