| ObjectiveTo observe the susceptibility,clinical manifestations,diagnosis,treatment of aortic dissection (AD), so as to improve understanding of this disease, and summarize the current situation about the treatment of the disease.MethodsTwenty-seven patients who were confirmed aortic dissection by the auxiliary examination were analyzed from March 2010 to March 2011 at The First Affiliated Hospital of Zhengzhou University retrospectively.Results1. History:15cases with hypertension among 27 patients (55.56%),1 case with diabetes (3.70%),1 case with coronary heart disease (3.70%),1 case with hypertension combined diabetes (3.70%),1 case with hypertension combined coronary artery disease (3.70%),8 cases long-term smokering (29.63%),1 case of trauma history (3.70%)2. Clinical symptoms:23 cases whose initial symptoms were pain (85.19%),17 cases were backache (62.96%),6 cases were abdominal pain (22.22%),1 case were lumbago (3.70%),2 cases were limbs pain (7.41%),1 cases were nausea and vomiting (3.70%),3 cases were respiratory symptoms:dyspnea and so on (11.11%) Signs:24 cases with elevated blood pressure of the patients, blood pressure levels 173.50±30.36/96.30±16.89 mmHg (plus or minus 1mmHg = 0.133 Kpa) (88.89%),11 cases with normal blood pressure (11.11%),5 cases had diastolic murmurs of aortic valve (18.52%),2 cases had the limbs pulsation weakness or disappearance (7.41%),3 cases whose bound of heart enlarged (11.11%) Complications:5 cases aortic had valve insufficiency (18.51%),3 cases had pericardial effusion (11.11%),4 cases had pleural effusion (14.81%),7 cases had renal disfunction (25.93%),2 cases had hepatic function abnormality (7.41%),3 cases had AD ruptured (11.11%)3. Diagnosis:21cases were diagnosed AD primarily (62.96%),6 cases were misdiagnosed as other illnesses (37.04%), included 4cases who were diagnosed as coronary artery disease chiefly (66.67%),1 case were diagnosed as heart failure (3.70%),1 case were diagnosed as digestive system disease (3.70%) 24 cases diagnosed according to CTA,8 cases diagnosed with MRI,13case diagnosed with ultrasound. According to Debakey grouping, AD is divided into three types, type I 4 cases (14.81%), typeⅡ6 cases (22.22%), typeⅢ17 cases(62.96%).4. Treatment:All patients were given conventional therapy after diagnosis,6 cases had drug expectant treatment example (33.33%), included 3 cases with AD ruptured (11.11%),17 cases had tectorial stent implantation (62.96%),1 case had surgical treatment (3.70%),6 cases had a fever after interventional treatment (35.29%) 3 cases died to AD ruptured(11.11%), the rest whose blood pressure and heart rate controled better.17 cases who had tectorial stents implantation were cured clinically (62.96%)Conclusions1. The man, age 40 to 70 years old, who had a history of hypertension, with pain for starting symptoms (especially backache pain), with elevated blood pressure should be highly suspected diagnosis as aortic dissecting.2. Those who were suspected diagnosis as aortic dissecting should be examined by CTA.3. For type III aortic dissection, tectorial stents implantation is the effective and promising treatment at present. |
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