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2023年7月 第38卷 第7期11
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经胸超声心动图在Stanford A型主动脉夹层的诊断及预后评估中的价值

The value of transthoracic echocardiography in the diagnosis and prognostic evaluation of Stanford type A aortic dissection

来源期刊: 广州医药 | 36-40 发布时间:2021-11-24 收稿时间:2025/11/13 18:09:20 阅读量:78
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关键词:
主动脉夹层超声心动图预后
Aortic dissectionEchocardiographyPrognosis
DOI:
10.3969/j.issn.1000-8535.2021.03.007
收稿时间:
2020-12-03 
修订日期:
 
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引用总数:
0  
目的 分析经胸超声心动图在Stanford A 型主动脉夹层的直接征象、间接征象和优缺点,探讨超声心动图在其诊断及预后评估中的应用价值。方法 回顾性收集2018年9月—2020年6月在我院诊治的A型主动脉夹层患者的临床资料,分析超声心动图的应用价值,以及住院期间发生不良预后的高风险因素。结果 经胸超声心动图直接征象诊断 A 型主动脉夹层的敏感性低于CTA,但对受累主动脉瓣结构及其功能评价优于CTA。 院内不良预后的发生率为42%, A型夹层的病因多与高血压相关,主动脉瓣返流、心包积液、手术时间长等是其高风险因素。结论 经胸超声心动图对A型主动脉夹层的早期诊断有较高的初筛价值,在局限于主动脉窦部夹层及观察主动脉瓣是否受累及有独特的优势,对于手术方式的选择和预后的判断有指导意义。
Objective To analyze the direct signs, indirect signs, advantages and disadvantages of transthoracic echocardiography in Stanford A-type aortic dissection, and explore the application value of echocardiography in its diagnosis and prognostic evaluation. Methods Retrospectively collect the clinical data of patients with type A aortic dissection diagnosed and treated in our hospital from Sept 2018 to Jun 2020, and analyze the application value of echocardiography and the high-risk factors for poor prognosis during hospitalization. Results The direct signs of transthoracic echocardiography were less sensitive than CTA in the diagnosis of type A aortic dissection, but it was better than CTA in evaluating the structure and function of the affected aortic valve. The incidence of poor prognosis in the hospital was 42%. The cause of type A dissection was mostly related to hypertension. Aortic regurgitation, pericardial effusion, and long operation time were high-risk factors. Conclusion Transthoracic echocardiography has a higher initial screening value for the early diagnosis of type A aortic dissection. It has unique advantages in confining to the aortic sinus dissection and observing whether the aortic valve is involved, the choice of surgical methods and the judgment of prognosis has guiding significance.
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