本文選題：妊娠　切入點：主動脈疾病　出處：《中國全科醫(yī)學》2015年14期

【摘要】：目的探討妊娠合并主動脈夾層的危險因素、臨床表現(xiàn)、診斷方法及治療手段。方法查閱中南大學湘雅二醫(yī)院2010—2013年1 271例主動脈夾層患者的病歷資料,篩選出9例妊娠合并主動脈夾層患者的臨床資料進行回顧性分析。結(jié)果妊娠早期1例,妊娠晚期及產(chǎn)褥期8例;既往有高血壓病史者2例,馬凡綜合征者4例,兩者兼有者1例;主要臨床表現(xiàn)為胸背部疼痛8例,胸悶、氣促1例。主動脈夾層分型采用Stanford分型標準,A型6例,B型3例;診斷方法包括非創(chuàng)傷性血管成像技術(shù)(CTA)和胸壁超聲心動圖(TTE)。Stanford A型患者1例保守治療,余5例均采取以Bentall術(shù)為基礎(chǔ)的手術(shù)治療,3例產(chǎn)婦及胎兒均存活;Stanford B型患者行主動脈夾層帶膜支架腔內(nèi)修復(fù)術(shù),產(chǎn)婦及胎兒均存活。結(jié)論妊娠合并主動脈夾層好發(fā)于妊娠晚期及產(chǎn)褥期,危險因素包括處于妊娠晚期及產(chǎn)褥期、合并高血壓或馬凡綜合征等,臨床表現(xiàn)以突發(fā)胸背部疼痛為主,診斷方法主要有TTE及CTA等,治療方案應(yīng)權(quán)衡產(chǎn)婦及胎兒情況、主動脈夾層分型等來綜合考慮。
[Abstract]:Objective to investigate the risk factors, clinical manifestations, diagnosis and treatment of aortic dissection in pregnancy. Methods the medical records of 1 271 patients with aortic dissection from 2010 to 2013 in Xiangya second Hospital of Central South University were reviewed. The clinical data of 9 cases of pregnancy complicated with aortic dissection were retrospectively analyzed. Results there were 1 case of early pregnancy, 8 cases of late pregnancy and puerperium, 2 cases of history of hypertension and 4 cases of Marfan syndrome. The main clinical manifestations were thoracic back pain in 8 cases, chest tightness in 1 case, and shortness of breath in 1 case. Aortic dissection was classified according to Stanford classification standard in 6 cases with type A and type B in 3 cases. The diagnostic methods included non-traumatic angiography (CTAA) and chest wall echocardiography (TTE.Stanford A). The remaining 5 cases were treated by Bentall's operation. 3 cases of parturient and 3 cases of fetal survival were treated with endovascular repair of aortic dissection with stent. Conclusion Aortic dissection is common in late pregnancy and puerperium. The risk factors include late pregnancy and puerperium, hypertension or Marfan syndrome, etc. The main diagnostic methods are TTE and CTA. The treatment should balance the maternal and fetal conditions, aortic dissection classification and so on.
【作者單位】： 中南大學湘雅二醫(yī)院急診科;
【分類號】：R714.252

【共引文獻】

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本文編號：1669981