不同夹层患者的疼痛特点及控制策略.docVIP

精品论文 参考文献 不同夹层患者的疼痛特点及控制策略 （绵阳市中心医院 四川绵阳621000） [摘要] 目的 探讨不同主动脉夹层类型患者的疼痛特点及相应的控制策略；方法 回顾性分析我院收治的24例Stanford B型夹层、11例Stanford A型夹层患者的一般资料及疼痛特点，都及时予以降压、控制心率、止痛、镇静等治疗；结果 35例患者经过内科治疗后，血压得到有效控制，疼痛明显减轻；24例B型夹层患者全部顺利过渡到手术期，9例A型夹层患者顺利过渡到手术期，2例A型夹层分别在入院后4h、9h由于夹层破裂而死亡。结论 Stanford A型夹层主要是前胸上部及后背部的撕裂样疼痛，往往伴有呼吸困难，Stanford B型夹层除胸背部疼痛外，还可能为腹部疼痛或不适等多种表现；其降压、止痛、镇静等治疗能有效控制患者疼痛，使其能平稳过渡到手术期。 【关键词】主动脉夹层；疼痛；治疗 【中图分类号】R543.16【文章标识码】A The pain characteristics of different dissection patients and control strategy [Abstract] Objective To investigate the characteristics of pain in patients with different types of aortic dissection and the corresponding control strategy; Methods A retrospective analysis of the general information on the characteristics of the patients pain in 24 Stanford B dissections, 11 cases of Stanford A dissections in our hospital and taken down promptly, control heart rate, pain, sedation and other treatment; Results The blood pressure of 35 patients has been effectively controlled, significantly reduced pain after medical treatment; 24 cases of type B dissections and 9 cases of type A dissections were all smooth transition the operative period, two cases of type A dissections were death due to dissection rupture after operative in 4h，9h. Conclusions Stanford A dissection is mainly the upper chest and back after tearing pain, often accompanied by difficulty breathing, Stanford B dissection in addition to the chest and back pain, may also be abdominal pain or discomfort, and other performance; control heart rate, pain, sedation and other treatment can effectively control pain in patients, making a smooth transition to the operative period. [Keywords] aortic dissection; pain; treatment 急性主动脉夹层是临床上较为常见的危急重症，AD国内年自然发病率约1/10万[1],而国外报道发病率为(3~4)/10万[2]。该病发病突然，病程进展快，死亡率高，临床表现多样；不同类型的主动脉夹层在疼痛表现上不尽相同；了解其疼痛特点，可以根据具体情况控制患者疼痛使其顺利过渡到手术期。 1 资料与方法 1.1 一般资料 35例急性主动脉夹层患者，其中24例Stanford B型夹层、11例Stanford A型夹层；男26例，女9例；年龄37-76岁，平均60.8岁；发病时间在9h-5d；既往患有高血压病史33例。 1.2