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目的探讨主动脉夹层(AD)患者猝死的原因、临床特点、病理基础,从而早期诊断,有效防治。方法回顾性分析8例AD猝死患者的临床尸检病理资料,结合文献探讨其发生、病理学改变、与死亡的关系以及检查方法和诊断要点。结果 AD临床表现复杂多样。病理特点为夹层壁内平滑肌细胞明显退行性变、弹力纤维减少或断裂、胶原纤维增生等改变。死亡原因:急性心包填塞6例,休克2例。结论 AD起病隐匿,但其一旦破裂或撕裂,则发病急骤,常导致严重后果。尽早防治动脉粥样硬化,有效控制高血压是预防AD的根本措施。
Objective To investigate the causes, clinical characteristics and pathological basis of sudden death in patients with aortic dissection (AD) so as to make early diagnosis and effective prevention and treatment. Methods A retrospective analysis of 8 cases of sudden death in patients with AD autopsy pathology data, combined with the literature to explore its occurrence, pathological changes, and the relationship between death and examination methods and diagnostic points. Results The clinical manifestations of AD are complex and diverse. Pathological features of the dissected wall smooth muscle cells significantly degenerative changes, reduction or break of elastic fibers, collagen fibrosis and other changes. Causes of death: acute tamponade in 6 cases, shock in 2 cases. Conclusion AD onset of occult, but once the rupture or tear, the incidence of sudden, often leading to serious consequences. Early prevention and treatment of atherosclerosis, effective control of hypertension is the fundamental measure to prevent AD.