摘要
本组研究了７０名主动脉夹层动脉瘤患者的临床特点、病因病理、影像学诊断、治疗与预后。３１～７０岁者占９３％．男女患病率之比为３．７：１。近端型与远端型之比为０．８：１。高血压者占６７％，马凡综合征占１８％．病理检查表现为中层弹力纤维稀疏、断裂、粘液性变、囊性坏死。８０％患者无发病诱因，７６％有胸痛、６９％为剧痛。胸片、超声、电子计算机断层（ＣＴ）磁共振显像（ＭＲｌ）结合临床可确诊本病。超声检查敏感性为９７％、特异性为９４％．近端型外科与内科治疗住院病死率分别为１４％与２２％．远端型分别为６３％与２７％．死亡原因６８％瘤体破裂出血。
he clinical features,etiologies,pathogenesis,treatment and prognosis of 70 patients with aortic dissecting were studied.Patients with age ranging from 31 to 70 vears consisted 93% of the total. The proportion of proximal to distal types is 0.8:1.Hypertension was present in 67 % and Marfan′s syndrome 18% of the patients. The pathologic finding was scattered rupture with myxomatous and cystic necrosis of the mecial elastic fibers. 80% of the patients suffered from the disease without anv in-ducing cause.Of the 76% patients had chest pain,it was very severe in 69%. Chest X一ray,ultrasound,computed tomography and magnetic resonance imaging together with clinical manifestations may accurately diagnose the disease. The sensitivity and specificity of the ultrasound are 97 % and 94% respectively.The mortality in hospital with surgical and medical therapy of the proximal type was 14% and 22% respectively, while that of the distal type was 63% and 27% respectively.Rupture of the aneurysm was the cause of death in 68% of the patients.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1994年第6期385-387,共3页
Chinese Journal of Internal Medicine
