基层诊治主动脉夹层10例体会

Experience in Primary Diagnosis and Treatment of 10 Cases of Aortic Dissection

摘要: 目的：旨在深入探讨基层医院在处理主动脉夹层(AD)这一复杂病症时的诊断与治疗策略。方法：回顾性选取我院2020年1月~2023年12月收治的10例AD患者。结果：首发症状，5例胸痛，2例腰背部疼痛，2例腹痛，1例单侧肢体麻木；伴随症状，7例心悸、气促，4例烦躁、多汗、面色苍白；其中8例血压升高，1例血压正常，1例血压下降；首发症状心悸、胸痛及急腹症者，最终通过彩超、增强CT或MRI检查确诊；有8例转院救治。结论：AD临床表现复杂多样，误诊率高，且致死性强。因此，基层医务人员需加强对该病的认识，以提高早期诊断的准确性和及时性，从而避免治疗延误。

Abstract: Objective: To explore the relevant measures of primary hospitals in the diagnosis and treatment of active dissection (AD). Method: Retrospective selection of 10 AD patients admitted to our hospital from January 2020 to December 2023. Result: Initial symptoms: 5 cases of chest pain, 2 cases of lower back pain, 2 cases of abdominal pain, and 1 case of unilateral limb numbness; Accompanied by symptoms, 7 cases had palpitations and shortness of breath, and 4 cases had restlessness, excessive sweating, and pale complexion; Among them, 8 cases had elevated blood pressure, 1 case had normal blood pressure, and 1 case had decreased blood pressure; Patients with initial symptoms such as palpitations, chest pain, and acute abdomen are ultimately diagnosed through ultrasound, enhanced CT, or MRI examination; Eight cases were transferred for treatment. Conclusion: The clinical manifestations of AD are complex and diverse, the disease progresses rapidly, the mortality rate is extremely high, the prognosis is poor, and it is prone to misdiagnosis. Therefore, primary hospital physicians should improve their understanding of this disease to avoid delaying diagnosis and treatment.