Stomach distension does not rule out visceral blood supply disorder, so it should be treated. Pay attention to eating digestible and semi-liquid food. It is very important to control blood pressure and heart rate. Do enhanced ct of aorta as soon as possible.
Aortic dissection can be treated by drugs, surgery and interventional therapy. The following is an introduction to the treatment of aortic dissection, hoping to help you:
Treatment of aortic dissection
Once suspected or diagnosed, you should be hospitalized for monitoring and treatment. The purpose of aortic dissection treatment is to reduce myocardial contractility, slow down left ventricular systolic velocity (dv/dt) and peripheral arterial pressure. The goal of aortic dissection treatment is to control systolic blood pressure at13.3 ~16.0kpa (100 ~120mmhg) and heart rate at 60~75 beats/min. This can effectively stabilize or stop the continued separation of aortic dissection, so that the symptoms can be alleviated and the pain can disappear. Treatment is divided into two stages: emergency treatment and consolidation treatment.
(1) First aid ① Pain relief: morphine and sedatives were used. ② Replenishing blood volume: If there is pericardial hemorrhage, transfusion should be given to those with ruptured thoracic cavity or aorta. ③ Lowering blood pressure: For patients with hypertension, Naylor 5mg can be given intermittently intravenously, and sodium nitroprusside 25~50μg/min can be given intravenously, and the dropping speed can be adjusted to reduce blood pressure to the clinical treatment index. It is a clinical indication that the pain is obviously relieved or disappeared after the blood pressure drops. Other drugs such as verapamil, nifedipine, captopril and prazosin can be selected. Reserpine is also effective by intramuscular injection of 0.5 ~ 2 mg every 4~6 hours. In addition, labetalol can also be used, which has double blocking effects of α and β, and can be intravenously dripped or orally taken. Attention should be paid to the following problems: hypertensive patients with aortic branch obstruction should not be treated with antihypertensive therapy because hypotension can aggravate ischemia. For patients with hypotension, antihypertensive drugs are not used, but Naylor can be used to reduce myocardial contractility.
(2) Patients with proximal aortic dissection, aortic dissection rupture or near rupture, and aortic valve insufficiency should be treated surgically. For slowly developing and distal aortic dissection, drug therapy can be continued. Keep the systolic blood pressure at13.3 ~16.0kpa (100 ~120mmhg). If the above drugs are not satisfactory, captopril 25~50mg can be taken orally three times a day.
(3) Surgical treatment
Stanford type A (equivalent to DeBakey type and type ii) needs surgery. DeBakey operation is an improved stent elephant trunk operation, in which the ascending aorta and aortic arch are replaced by artificial blood vessels. Debakey ii was performed by artificial vascular replacement of ascending aorta.
If aortic valve insufficiency or coronary artery involvement occurs, aortic valve replacement and bentall should be performed at the same time.