作者：李波，吴春蓉，吴灿

单位：

1.402260重庆市，重庆大学附属江津医院 重庆市江津区中心医院心内科　 2.402260重庆市，重庆大学附属江津医院 重庆市江津区中心医院肿瘤科 通信作者：吴灿，E-mail：304012548@qq.com

Units：

1.Department of Cardiology, Chongqing University Jiangjin Hospital/Central Hospital of Jiangjin District, Chongqing,Chongqing 402260, China 2.Department of Oncology, Chongqing University Jiangjin Hospital/Central Hospital of Jiangjin District, Chongqing,Chongqing 402260, China Corresponding auther: WU Can, E-mail: 304012548@qq.com

关键词：

主动脉疾病; 急性主动脉综合征; 胸痛; 主动脉瘤; CT血管造影术; 病例报告;

Keywords：

Aortic diseases; Acute aortic syndrome; Chest pain; Aortic aneurysm; Computed tomography angiography;Case reports

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.075

Funds：

重庆市第三批区域医学重点学科建设项目（zdxk201806）；重庆市江津区科学技术局科技计划项目（Y2020050）

摘要：

随着竞争性压力日益加剧及不良的生活习惯，心血管疾病的发病率急剧上升，而急性主动脉综合征（AAS）作为临床上的急危重症，严重威胁着患者的生命健康及生活质量。在临床工作中，AAS常以持续性胸痛或背部疼痛为主要临床症状，由于部分AAS患者疼痛性质不典型，临床上容易对这类疾病误诊，从而影响患者治疗的及时性及规范性，严重影响患者预后。本文报道1例于2021-09-18就诊于重庆市江津区中心医院的非典型AAS患者，其完善CT及CT血管造影（CTA）确诊，并成功进行了腔内动脉修复术，术后临床症状完全缓解，预后良好。阐述了临床上部分AAS患者发病的不典型性及隐匿性，可能让临床医务工作者出现误诊。这就要求临床医师要加强基本知识及基本技能的培养，需要详细询问病史，仔细进行体格检查，全面提高诊断及鉴别诊断能力，及时完善必要的辅助检查，明确相关致命的胸痛性疾病，以挽救更多生命。

Abstract：

【Abstract】 With the increasingly intensified competitive pressure and bad living habits in modern times, the incidenceof cardiovascular diseases has risen sharply, while acute aortic syndrome (AAS) , as a clinical critical and severe disease, seriouslythreatens the life, health and quality of life of patients. In clinical work, persistent chest pain or back pain is often the main clinicalsymptom of AAS. Due to the atypical nature of pain in some AAS patients, it is easy to misjudge this kind of disease clinically,thus affecting the timeliness and standardization of treatment and seriously affecting the prognosis of patients. This article reportsa case of atypical AAS patient who was admitted to the Central Hospital of Jiangjin District, Chongqing at 2021-09-18, CT andCT angiography (CTA) were improved to confirm the diagnosis and intracavascular artery repair was performed successfully. Theclinical symptoms were completely relieved after operation and the prognosis was good. This paper expounds the atypia and occultof some AAS patients, which may lead to misdiagnosis by clinical medical workers. This requires clinicians to strengthen thetraining of basic knowledge and basic skills, inquire about the medical history in detail, perform a careful physical examination,comprehensively improve the ability of diagnosis and differential diagnosis, improve the necessary auxiliary examinations in time,and identify the relevant fatal chest pain diseases in order to save more life.

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