标题：急诊床旁经胸超声心动图联合多层螺旋CT在主动脉夹层诊断中的应用价值

      作者：董辉 1，张会芳 1，李兆洋 1，曹姗 2    (保定市第一中心医院急诊科 1、神经内一科 2，河北 保定 071000）

      卷次： 2017年28卷8期

      【摘要】 目的 探讨急诊床旁经胸超声心动图(TTE)联合多层螺旋CT (MSCT)在主动脉夹层(AD)诊断中的应用价值。方法 选择 2014年 1月至 2015年 12月收治的AD患者 48例，均给予TTE与MSCT检查，比较TTE联合MSCT检查AD与单纯TTE或MSCT检查的准确率，以及AD破裂口、血栓、心包积液检出率。结果 TTE、MSCT对 48例AD检查，检出率均为 100.00% (48/48)，TTE联合MSCT诊断AD分型准确率为 100.00%(48/48)，高于单纯TTE、MSCT检查的83.33% (40/48)、93.75% (45/48)，差异均有统计学意义(P<0.05)；TTE联合MSCT对AD破裂口检出率为95.83% (46/48)，高于单纯TTE、MSCT检查的33.33% (16/48)、81.25% (39/48)，差异有统计学意义(P<0.05)；TTE联合MSCT检查对血栓、心包积液检查检出率分别为 95.24% (20/21)、100.00% (16/16)，高于单纯TTE检查的71.43% (15/21)、75.00% (12/16)，差异均有统计学意义(P<0.05)。结论 TTE联合MSCT检查可提高AD分型诊断准确率及破裂口、血栓、心包积液检出率。
      【关键词】 经胸超声心动图；多层螺旋CT；主动脉夹层
      【中图分类号】 R543.1 【文献标识码】 A 【文章编号】 1003—6350（2017）08—1285—03

Clinical value of emergency bedside echocardiography combined with multi-slice spiral CT in the diagnosis ofaortic dissection.
DONG Hui 1, ZHANG Hui-fang 1, LI Zhao-yang 1, CAO Shan 2. Department of Emergency 1, FirstDepartment of Neurology 2, Baoding First Central Hospital, Baoding 071000, Hebei, CHINA
【Abstract】 Objective To explore the clinical value of emergency bedside echocardiography (TTE) combinedwith multi-slice spiral CT (MSCT) in the diagnosis of aortic dissection (AD). Methods A total of 48 cases of pa-tients with AD, who admitted to our hospital from January 2014 to December 2015, were selected and all given TTEand MSCT examination. The accuracy rate of TTE combined with MSCT in the treatment of AD was compared withtheir respective accuracy rate, and the detection rates of rupture port, thrombus, pericardial effusion were also com-pared. Results The detection rates of MSCT and TTE in the treatment of AD were 100.00% (48/48). The accuracy rateof TTE combined with MSCT in the diagnosis of AD was 100.00% (48/48), which was significantly higher than 83.33%(40/48) and 93.75%(45/48) of the respective TTE and MSCT examination (P<0.05). The detection rate of the AD ruptureport with TTE combined with MSCT was 95.83% (46/48), which was significantly higher than 33.33% (16/48) and81.25% (39/48) with respective TTE and MSCT examination (P<0.05). The detection rates of TTE combined withMSCT in the treatment of thrombus, pericardial effusion were respectively 95.24% (20/21) and 100.00% (16/16), whichwere higher than 71.43% (15/21) and 75.00% (12/16) of respective TTE examination (P<0.05). Conclusion TTE com-bined with MSCT can improve the diagnostic accuracy of AD typing and the detection rate of rupture, thrombus, andpericardial effusion.
      【Key words】 Echocardiography; Multi-slice spiral CT; Aortic dissection·论 著·doi:10.3969/j.issn.1003-6350.2017.08.028