摘要
主动脉壁内血肿(IMH)是急性主动脉综合征的一种,根据Stanford分型IMH可以分为A型和B型,其主要的发病机制为主动脉壁滋养血管破裂和主动脉穿透性溃疡.急性发作的胸痛通常为首发或唯一症状.可通过经胸超声心动图、经食管超声心动图、CT和磁共振成像等影像学检查诊断,其中以CT为首选检查.Stanford A型IMH目前多以手术治疗为主,也有进行药物治疗的研究和报道;Stanford B型IMH一般以药物治疗为首选.目前Stanford A型IMH并发症和死亡率均高于B型.本文主要对IMH的病理学特点、诊断和治疗做一综述.
Abstract
Intramural hematoma(IMH)is a type of acute aortic syndrome,According to the Stanford classification,it can be divided into type A and type B.It is currently widely believed that its primary pathogenesis is rupture of the aortic wall vasa vasorum and aortic penetrating ulcer.Acute onset chest pain is usually the first or only symptom.It can be diagnosed through imaging examinations such as transthoracic echocardiography,transesophageal echocardiography,CT,and magnetic resonance imaging,with CT being the preferred examination.Stanford type A IMH is currently primarily treated with surgery,but there are studies and reports on drug treatment.Stanford type B IMH is generally treated primarily with medication.Currently,the complication and mortality rates of Stanford type A IMH are higher than those of type B.This article provides a comprehensive review of the pathological characteristics,diagnosis,and treatment of IMH.
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