Clinical Analysis Of130Cases For Aortic Dissection And Identification With Pulmonary Embolism

Objective:Analysis of patients with aortic dissection(AD), and compared to clinical feature of pulmonary embolism(PE) patients who admitted to hospital in the same period, explore the risk factors, early diagnosis, misdiagnosis of aortic dissection, through the comparative analysis to find out the methods of rapid identification of pulmonary embolism.Methods:First, according to Stanford type, retrospective analysis clinical data of130patients with aortic dissection in First Affiliated Hospital of Guangxi Medical University form Nov2003to Aug2011; Second, compared with177in-hospital patients with pulmonary embolism during the same time. Analyzed the clinical characteristics, complication, laboratory and instrumental examinations between the two groups.Result:The mean age at onset of AD is (52.98±12.61)years, male:female ratio of nearly5.84:1, winter and spring for high incidence season. Accounted for84.62%of pain as the first symptom(110/130), the incidence of patients with Marfan syndrome, pericardial effusion, syncope, burred mind and the mortality was higher in Stanford type A than type B (all P<0.05), but incidence of hypertension in type B is higher than type A (P<0.05). The chest X-ray and TTE play a certain role in diagnosis of AD, which include aorta and/or mediastinum widened, cardiac enlargement, unilateral pleural effusion and TTE find out the intimal flap, break, pericardial effusion, aortic valve regurgitation. Comparative analysis indexes between aortic dissection and pulmonary embolism, the majority of patients are middle-age men. The incidence of hypertension and smoking in patient with AD was higher than PE (P=0.000,0.002), and there are significant different about HGB, ALB, PT, FIB, BUN, CCr between the two groups (P=0.046,0.000,0.006,0.029,0.020,0.009, respective). With the result of TTE, we found that aortic root diameter, interventricular septal thickness, right ventricular diameter, right ventricular outflow tract, main pulmonary artery, left ventricular posterior wall thickness difference in two groups was statistically (all P<0.05)Conclusion:Hypertension and smoking are risk factors for dissection. There are various clinical manifestations about aortic dissection and pulmonary embolism, TTE can be used as the preferred equipment method to identify patients of these diseases, who hemodynamic instability.