11例中青年主动脉夹层的早期鉴别和护理.docVIP

11例中青年主动脉夹层的早期鉴别及护理 孙道玉 辛绍伟 马学萍 刘蓓 （山东大学附属省立医院血管外科 山东 济南 250021） 【摘要】目的：主动脉夹层(aortic dissection，AD) 【关键词】主动脉夹层；中青年；临床特点；预后 Aortic dissection in young and middle-aged patients: a report of 11 cases. Sun Dao Yu, Xin Shao Wei, Ma Xue Ping, Liu Bei,Provinal Hospital Affiliaed To Shandong University, Jinan 250021, China Abstract 　Objective: Aortic dissection rarely happened in young and middle-aged patients. But there is a trend of increase. In order to meliorate outcome of aortic dissection in young and middle-aged patients, clinical epidemiology features of them were summarized. Method: From March 2002 to April 2007, we treated 29 cases of aortic dissection. Among them 11 patients were young and middle-aged people with their age less than 50 years. Their clinical characteristics were analyzed retrospectively to summarized the epidemiology features of aortic dissection in young and middle-aged patients. Result: Hypertension, dyslipidemia and diabetes were present less in young and middle-aged patients than eldly patients. But in young and middle-aged patients there were more patients whose aorta had been rupture when been admissed. Also more young and middle-aged patients need surgical reconstruction left upper extremity circulation, right subclavian artery (RSA)- left subclavian artery(LSA)bypass, before completely covered LSA. And more young and middle-aged patients had temporarily ischemic complications in left upper extremity whose LSA were not reconstructed. Mortality was higher in young and middle-aged patients. Conclusion: The etiology of aortic dissection in young and middle-aged patients was complex. Arteriosclerosis is not the mean cause of aortic dissection, while activated T cells and macrophages in the media of aorta may contribute to the elimination of smooth muscle cells and degradation of the matrix associated with aortic dissections. Aortic dissection in young and middle-aged patients progressed more quickly and perioperational mortality was higher. E