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目的:分析总结主动脉壁内血肿的临床特点、诊断及治疗,以便早期正确处理,降低病死率。 方法:回顾性分析连续21例经电子束计算机断层摄影术(EBT)确诊的主动脉壁内血肿住院患者的临床资料,并进行随访。 结果:21例患者均有突发持续胸背痛,高血压18例,一半以上患者有血白细胞、中性粒细胞、血沉、C-反应蛋白升高,部分患者X线胸片、经胸超声心动图可见非特异性征象,而EBT均可见特异性征象。其中Stanford A型4例,Stanford B型17例。除1例Stanford A型行外科手术外,均给予降压及负性肌力药物治疗,病情好转出院。共随访到17例,1例Stanford A型死亡,1例Stanford A型进展为典型主动脉夹层,4例Stanford B型血肿吸收好转,其余11例无症状存活,但未复查EBT。 结论:综合分析临床资料,可提高对主动脉壁内血肿的早期识别,有助于选择合适的治疗方法并改善预后。
OBJECTIVE: To analyze and summarize the clinical features, diagnosis and treatment of intraaortic aortic hematoma in order to correct early treatment and reduce mortality. Methods: The clinical data of 21 consecutive inpatients with intra-aortic intima confirmed by electron beam computed tomography (EBT) were retrospectively analyzed and followed up. Results: Twenty-one patients had sustained thoracic-back pain and hypertension in 18 cases. More than half of the patients had blood leukocyte, neutrophil, erythrocyte sedimentation rate and elevated C-reactive protein. Some patients had X-ray, transthoracic ultrasonography Cardiograph shows nonspecific signs, while EBT shows specific signs. Among them, 4 were Stanford type A and 17 were Stanford type B. In addition to a case of Stanford A type of surgical operation, were given antihypertensive and negative inotropic drugs, the condition improved and discharged. A total of 17 cases were followed up. One died of type Stanford A, one type of Stanford type A progressed to a typical aortic dissection. Four cases of Stanford type B hematoma improved and the remaining 11 cases survived asymptomatically without EBT. Conclusion: Comprehensive analysis of clinical data can improve the early identification of intra-aortic hematoma, which can help to select the appropriate treatment and improve the prognosis.