| Objective:To investigate the changes of the risk factors,diagnosis and treatment for acute aortic dissection(AAD)during the past ten years in western Guangxi area and its impact on prognosis,to summarize experiences in the diagnosis and treatment of AAD so as to improve people's awareness of AAD.Methods:In this retrospective analysis 72 cases of AAD patients treated in Hospital of Youjiang Medical University for Nationalities during the past ten years was divided into two groups for analyzing the changes of general information of patients,risk factors,treatment and disease outcome.Patients from January 2007 to December 2011 were recruited into group1(n=13)and those from January 2012 to December 2016 were recruited into group2(n=59).Results:(1)There was a significant increase in the number of AAD cases between 2007 and 2016,13 cases in group1 and 59 cases in group2.There were 46 cases increased after five-year periods,and the total number of cases increased by 354.00%.To compare group1 and group2,Type B is the fastest growing among all AAD,with an increase of 516.67%.(2)All patients were confirmed by CT,CTA,DSA or UCG in 72 cases.There were 58 males(80.55%)and 14 females(19.45%),the ratio of male to female was 4.14:1 and the average age was(55.00 ± 15.13)year.(3)Between 2007 and 2016,the median time for definite diagnosis was 1(1,2)days in 72 patients with AAD.The median time of definite diagnosis was 3(1,4.5)days in Group1,and the median time of definite diagnosis was 1(1,2)days in Group2.There was significant difference between the two groups in the average definitediagnosis time(P<0.05).Compared with group1,the time of definite diagnosis of group2 was significantly shorter.There was significant difference in the composition ratio of definite diagnosis between the two groups(P<0.05).The total usage rates of four imaging examinations in 10 years was 90.28% for CT,83.33% for CTA,34.72% for DSA,61.11% for UCG.There was not significant difference in the usage rates of the four imaging examinations between the two groups(P>0.05).(4)The two groups of patients with risk factors:Hypertension(83.33%)and long-term heavy smoking history(48.61%)were the main risk factors in western Guangxi area,the difference was not statistically significant in the risk factors between Group1 and group2(P>0.05).(5)For three kinds of treatment[conservative medical treatment,thoracic endovascular aortic repair(TEVAR)and surgical hybridization],there was a significant change in the usage rate between Group1(84.62%?7.69%?7.69)and Group2(62.71%?35.59%?1.69%).To compare with the first five years,the usage rate of TEVAR was significantly increased but the difference was not statistically significant(P>0.05).(6)The effective rates of treatment in group1 and group2 were respectively53.85% and 93.75%.The in-hospital fatality rates were 46.15% and 6.25% respectively.There was significant difference between the two groups in the treatment efficiency and fatality rates(P<0.05).Conclusion:(1)In-patients with AAD in western Guangxi area have a graduall increase over the past 10 years.The proportion of male patients is significantly higher than that of females.Compared with data reported abroad,the average age of pathogenesis is relatively low.(2)The major risk factors of AAD has no significantly change,Hypertension and long-term heavy smoking history are still the major risk factors of AAD.(3)With the advancement of imaging diagnostics and treatments,the time for definite diagnosis of AAD is significantly shorter,at the same time,the application of TEVAR is gradually increasing,the efficiency of AAD is greatly improved,and the fatality rates in hospital shows a downward trend in western Guangxi area.In addition,surgical hybridization for treatment of AAD hasnot been widely used and applied in western Guangxi area. |
PDF Full Text Request