妊娠合并主动脉夹层临床资料分析

妊娠合并主动脉夹层临床资料分析
杨贵芳;彭文;赵琴;柴湘平
【期刊名称】《中国全科医学》
【年(卷),期】2015(000)014
【摘要】目的：探讨妊娠合并主动脉夹层的危险因素、临床表现、诊断方法及治疗手段。

方法查阅中南大学湘雅二医院2010—2013年1271例主动脉夹层患者的病历资料，筛选出9例妊娠合并主动脉夹层患者的临床资料进行回顾性分析。

结果妊娠早期1例，妊娠晚期及产褥期8例；既往有高血压病史者2例，马凡综合征者4例，两者兼有者1例；主要临床表现为胸背部疼痛8例，胸闷、气促1例。

主动脉夹层分型采用 Stanford 分型标准，A 型6例，B型3例；诊断方法包括非创伤性血管成像技术（ CTA）和胸壁超声心动图（TTE）。

Stanford A 型患者1例保守治疗，余5例均采取以 Bentall 术为基础的手术治疗，3例产妇及胎儿均存活；Stanford B 型患者行主动脉夹层带膜支架腔内修复术，产妇及胎儿均存活。

结论妊娠合并主动脉夹层好发于妊娠晚期及产褥期，危险因素包括处于妊娠晚期及产褥期、合并高血压或马凡综合征等，临床表现以突发胸背部疼痛为主，诊断方法主要有 TTE 及 CTA 等，治疗方案应权衡产妇及胎儿情况、主动脉夹层分型等来综合考虑。

%Objective To explore the risk factors,clinical manifestations,diagnoses and treatments of pregnancy with aortic dissection(AD). Methods The clinical data of 1 271 AD patients were collected,who visited the 2nd Xiangya Hospital of Central South University from 2010 to 2013 and 9 pregnancy patients complicated by AD were screened out. Results There was 1 patient in early pregnancy,8 in late
pregnancy and postpartum period. Two had history of hypertension,4 had Marfan syndrome,1 had both. The main manifestations were:thoracic back pain in 8 patients,chest tightness and shortness of breath in 1. AD typing by Stanford classification criteria were:6 cases of A type,3 of B type. Diagnostic methods included non- invasive computed tomographic angiography(CTA)and transthoracic echocardiography( TTE). One patient of type A was given conservative treatment,the other 5 given surgical treatment based on Bentall technique,3 lying - in women and infants survived. The patients of type B were given " AD stent endovascular repair",the lying - in women and infants survived. Conclusion Pregnancy with AD is common in late pregnancy and postpartum period. Its risk factors include late pregnancy and postpartum period,combined with hypertension or Marfan syndrome,etc. Its manifestations are mainly sudden thoracic back pains and its diagnostic methods are TTE and CTA. Its treatment options should be considered comprehensively by balancing maternal and fetal conditions,AD types,etc.
【总页数】3页(P1720-1722)
【作者】杨贵芳;彭文;赵琴;柴湘平
【作者单位】410011 湖南省长沙市，中南大学湘雅二医院急诊科;410011 湖南省长沙市，中南大学湘雅二医院急诊科;410011 湖南省长沙市，中南大学湘雅二医院急诊科;410011 湖南省长沙市，中南大学湘雅二医院急诊科
【正文语种】中文
【中图分类】R714.144;R543.1
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