The arterial blood vessels of ordinary people are mainly divided into three structures, namely the media, intima, and adventitia. These three layers are closely adhered to each other and work together to ensure the passage of blood. The cause of aortic dissection is the local tearing of the intima, which leads to its expansion and detachment under the impact of blood, forming true and false lumens in the artery. Due to this reason, it can lead to some tearing like pain.
1、 Causes of aortic dissection
The main cause of aortic dissection is the interaction of abnormal hemodynamics and aortic abnormal mesomembrane structure. When the aortic structure is abnormal, it is easy to cause the phenomenon of aortic dehiscence. The more common factors are: congenital cardiovascular malformation, Marfan syndrome, aortic atherosclerosis, and so on.
Both American female volleyball player Heyman and male volleyball player Zhu Gang, whom we are familiar with, fell onto the sports field due to this reason. When the dynamics of blood flow change, there is also a high probability of arterial wall damage, and the most common phenomenon is hypertension. Patients with aortic dissection are basically unable to control their hypertension.
2、 The hazards of aortic dissection disease
The biggest hazard of aortic dissection disease is death, because the aorta is an active blood vessel in the body and directly bears the pressure from the beating of the heart. Therefore, the blood flow inside is very large. If not treated in a timely and appropriate manner, there is a high possibility of damage, so the probability of death is also very high. According to relevant literature, the probability of death in this case within a week is as high as 50%, and the probability of death within a month is between 60% and 70%.
3、 The treatment methods for aortic dissection mainly include surgical treatment, conservative treatment, and interventional treatment.
Firstly, conservative treatment methods are the foundation and the first choice, regardless of which treatment method is used. They are achieved by controlling blood pressure and pain, and often require the use of strong drugs such as morphine for pain relief and sodium nitroprusside for blood pressure reduction. For some patients with urgent situations, ventilators should be used for assisted breathing, emergency tracheal intubation or emergency surgery should be used for rescue. However, this method also means a high risk and mortality rate.
The next steps are surgical and interventional treatment. Once the patient's condition stabilizes, the specific treatment method should be determined based on the actual type of dissection. Currently, Stanford B's treatment for aortic dissection mainly involves minimally invasive endovascular methods, which are based on the following conditions: the dissection continues to expand, mainly manifested as an increase in the size of the aortic dissection, an increase in the diameter of the dissection, uncontrollable pain, and chest bleeding; Or it could be ischemia in some branches of the aorta, such as the mesenteric artery and renal artery. In the past, traditional minimally invasive endovascular repair surgery for aortic dissection required a minimum anchoring zone of 1.5 centimeters above the aorta to prevent incomplete proximal occlusion or internal leakage. However, with the advancement of endovascular repair technology and the improvement of endovascular repair equipment, this indication has also expanded to a certain extent. Endovascular repair techniques or hybrid surgery can be used to treat Stanford B type aortic dissection within 1.5 centimeters of the left subclavian artery opening from the main fissure.
4、 Prevention methods for aortic dissection
For patients with hypertension, it is necessary to measure blood pressure at least twice a day to ensure a healthy lifestyle. Medication should be used to control blood pressure within a relatively normal range, and appropriate physical labor should be performed, but not intense physical labor. Regular check ups should be conducted in daily life to monitor the condition regularly. If any abnormal phenomena are found, doctors should be sought for correct treatment.
In daily life, it is important to reduce smoking because there is a close relationship between aortic aneurysm and smoking, and the large amount of components in cigarettes can cause a weakening of the arterial wall. For patients with hypertension, it is even more important to eliminate smoking.
5、 The nursing methods for aortic dissection include basic care. After the patient is admitted to the ICU, absolute bed rest should be ensured, and strict monitoring of changes in blood pressure, electrocardiogram, respiration, heart rate, and other physical signs should be carried out. If any abnormal phenomena are found, they should be reported to the doctor in a timely manner. During the patient's diet, semi liquid soft foods or soft foods should be consumed, and bowel movements should be ensured to be smooth. Appropriate medication for defecation can be taken, and force should not be exerted during defecation to prevent worsening of the condition.
Secondly, there is a psychological nursing approach, as patients may suddenly experience severe pain, such as abdominal tearing, which can lead to anxiety and fear. Additionally, the need for absolute bed rest and unfamiliarity with the equipment and monitoring environment can exacerbate the patient's fear, which is not beneficial for controlling their blood pressure and heart rate. So this requires family members and nurses to comfort and care for patients in a timely manner, so that patients can eliminate worries and nervousness, and actively cooperate with doctors' treatment.
Finally, sedation and pain relief can be used, as the swollen area of an aortic aneurysm can cause severe pain due to continuous extension. Therefore, general and effective analgesics can be used in moderation, such as intravenous infusion or injection of five to ten milligrams of morphine, or intramuscular injection of fifty to one hundred milligrams of Dulagliptin. These drugs can achieve a calming and sedative effect, while also reducing patients' anxiety and fear, allowing them to better cooperate with treatment. If pain repeatedly occurs, be alert to whether it is a diffusion phenomenon of the blood vessels in the interlayer.
Overall, aortic dissection is still an extremely dangerous case, and if not treated in a timely manner, it is likely to affect the patient's life. Therefore, it is necessary for people to have sufficient understanding of this case, maintain a regular diet in daily life, undergo regular physical examinations, and seek medical attention promptly if similar phenomena are found.