Application Value of Bedside Echocardiography in Stanford Type A Aortic Dissection
Objective To explore the value of bedside echocardiography in the diagnosis and prognosis evaluation of Stanford type A aortic dissection(AD).Methods A total of 80 patients diagnosed with Stanford A type AD who were admitted to the First Affiliated Hospital of Xiamen University from July 2021 to June 2023 were selected as the study subjects.All patients underwent transthoracic echocardiography(TTE)at bedside after admission.Clinical data of the patients were retrospectively analyzed,and the accuracy of bedside TTE in diagnosing Stanford A type AD was evaluated.In addition,echocardiographic findings of patients with in-hospital death and survival in Stanford type A AD detected by TTE at bed were compared,and the relationship between TTE findings at bed and in-hospital death in Stanford type A patients was statistically analyzed,so as to evaluate the value of TTE at bed in evaluating patients'prognosis.Results A total of 78 cases of Stanford A type AD were detected by bedside TTE,and 2 cases were missed,with a diagnostic accuracy rate of 97.50%.There was no statistically significant difference in pericardial effusion rate,left ventricular ejection fraction(LVEF)<50%,aortic sinus dilation rate,and total aortic regurgitation rate between survival and death patients with Stanford type A AD(P>0.05).The diameter of the aortic root and ascending aorta in death patients was larger than that in survival patients,and the proportion of aortic valve involvement and severe aortic regurgitation was higher than that in survival patients,the difference was statistically significant(P<0.05).Logistic regression analysis showed that the diameter of the aortic root Aortic valve involvement,ascending aortic diameter,and severe aortic regurgitation are independent influencing factors for in-hospital mortality in Stanford A type AD patients.The analysis results of receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of the above four items were all>0.7.Predicted in-hospital death in Stanford type A AD patients with the highest combined predictive value(AUC=0.815).Conclusion Bedside TTE has a high accuracy in diagnosing Stanford A type AD and can provide a basis for clinical emergency treatment.Increased aortic root diameter,aortic valve involvement,ascending aortic diameter,and severe aortic regurgitation are risk factors for hospital mortality in Stanford A type AD.Monitoring these indicators with bedside TTE can provide valuable references for evaluating patient prognosis,and combined application has higher predictive value.
aortic dissectionStanford A typebedside echocardiographydiagnosisprognosisclinical efficacy
万方数据
维普
