Dissection of the Aorta: Current Diagnostic and Therapeutic Approaches
Dissection of the Aorta: Current Diagnostic and Therapeutic Approaches
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主动脉夹层：当前的诊断和治疗方法
DOI：
10.1001/jama.1979.03300140046025
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发表时间：
1979
期刊：
影响因子：
--
通讯作者：
J. Howe
中科院分区：
文献类型：
--
作者：
J. Dalen;J. Howe
主动脉夹层是主动脉最常见的急性疾病。如果不进行治疗，它是高度致命的。在赫斯特等人的经典系列中，1 62%的患者在症状出现后7天内死亡，93%在一年内死亡。很少有病人会立即死亡；大多数人存活的时间足以做出诊断。如果临床医生认识到主动脉夹层，他现在就可以进行非常成功的药物或手术治疗。通过适当的治疗，夹层的死亡率低于 20%。 2 主动脉夹层的识别很困难，因为它几乎总是与急性心肌梗塞相混淆。病理生理学 易于发生夹层的病变是囊性内侧坏死。 3 囊性内侧坏死的原因尚不清楚。我们确实知道高血压和马凡氏综合症容易导致中层病变
DISSECTION of the aorta is the most common acute disease of the aorta. Without therapy, it is highly lethal. In the classic series of Hirst et al, 1 62% of the patients were dead within seven days of the time of the onset of symptoms, and 93% were dead within a year. Few patients die instantaneously; the majority survive long enough for the diagnosis to be made. If the clinician recognizes dissection of the aorta, he now has available highly successful medical or surgical therapy. With appropriate therapy, the mortality of dissection is less than 20%. 2 Recognition of aortic dissection is difficult because it is almost always confused with acute myocardial infarction. Pathophysiology The lesion that predisposes to dissection is cystic medial necrosis. 3 The cause of cystic medial necrosis is unknown. We do know that hypertension and Marfan's syndrome predispose to this lesion in the media of the