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首頁網誌腹腔與胸腔主動脈瘤 - 無聲殺手

腹腔與胸腔主動脈瘤 - 無聲殺手

2/27/2019 | 來自: Medix團隊
腹腔與胸腔主動脈瘤 - 無聲殺手

主動脈瘤是猝死的最常見原因之一 (特別是60歲以上的男性),因此常被稱為「無聲殺手」。患者多數在動脈瘤破裂前都不會出現任何徵狀,故導致高達75%的發病率。

 

主動脈是人體最大的血管。雖然它十分堅韌耐用,但血管壁卻會因主動脈瘤而弱化和膨脹。在多數腹部動脈瘤個案中,患者有高機率同時出現血栓。這些小血塊會圍繞著動脈瘤形成,並有機會因分裂而流到心臟、雙腿、腎臟或其他器官,從而引起心臟病、腎臟受損及中風。若患者沒有適時治療,更有可能導致主動脈撕裂,令腹部、腰窩、腹股溝或背部出現撕裂痛,更可能因此失去意識,甚至死亡。

 

主動脈瘤有機會出現在兩個部位:胸部發現的就是胸主動脈瘤(TAA);若於腹部發現則為腹腔主動脈瘤(AAA)。

 

成因及徵狀

 

就如很多病症一樣,基因對一個人患上主動脈瘤的機會有著關鍵影響。至於其他因素則包括動脈二尖瓣、馬凡氏症候群和Loeys–Dietz症候群。

 

其他因素包括:

  • 吸煙
  • 高血壓
  • 感染
  • 動脈粥樣硬化
  • 高膽固醇
  • 突發性創傷

 

需要留意的警號:

  • 非骨科疾病相關的胸痛或背痛
  • 呼吸或吞嚥困難
  • 呼吸急促
  • 聲嘶
  • 腹部兩側深度痛楚
  • 肚臍附近抽痛

 

檢查,診斷及預防

 

一般常規檢查就能夠檢測出腹部主動脈瘤,醫學研究亦指出約30%的胸主動脈瘤患者是在常規身體檢查時檢測出無症狀的腹部腫塊。主診醫生可能會建議超聲波檢查,尤其是當患者是屬於高危組別,例如65至75歲有吸煙習慣的男性。同時也建議家族有胸主動脈瘤病史的60歲以上男士定期進行篩查。在確診家族性TAA的家庭中,建議不論男女都應在25歲時開始進行篩查,但若最年輕的患者是在25歲或以前患上腹腔主動脈瘤,則建議其餘家人在該歲數的提前十年開始進行篩查。

 

對於患主動脈瘤的高危人士,他們應該避免吸煙並保持健康的血壓水平。至於已被診斷患上小型主動脈瘤的人士,他們的醫療管理方案可使用斯達汀,並偶爾使用β受體阻斷劑。在相關個案中,需要進行定期超聲波檢查以監察主動脈瘤的增長。



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