摘要目的：探讨主动脉食管瘘的病因、诊断、治疗方式及预后，以提高对该病的认识，争取早期治疗。方法对2002年1月至2014年12月首都医科大学附属北京安贞医院主动脉食管瘘病例资料进行回顾性分析，并结合文献对该病的病因、诊断、治疗方式及预后进行总结。结果共纳入病例6例，其中男5例、女1例，平均年龄49岁（27～71岁）。病因为食管异物者1例，主动脉瘤者2例，主动脉术后者3例。6例均出现呕血，其中3例表现为前哨性出血，1例表现为前哨性出血后突发大出血，2例直接表现为突发大量呕血。前哨性出血4例病例中2例伴有胸痛，1例伴有吞咽困难，1例伴有发热。6例患者中2例有高血压病史。经胃镜或 CT 检查疾病诊出率为100％。4例死于失血性休克，2例经手术治疗后治愈。结论对伴有高血压病、主动脉疾病及食管异物的患者如出现间断少量呕血、胸痛、吞咽困难、无症状间歇期后大出血，应高度警惕主动脉食管瘘，迅速完善相关检查并采取手术等有效抢救措施。

abstractsObjective To investigate the pathogenesis,diagnosis,treatment and prognosis of aort-oesophageal fistula(AEF).Methods Retropective analysis was performed on 6 patients presenting with AEF between January 2002 and December 2014,and relative literature was reviewed on its pathogenesis,di-agnosis,prognosis and treatment.Results Five men and 1 woman with a mean age of 49 (range,27-71 years)were recruited to the study.One case of AEF was caused by esophageal foreign body,2 cases were caused by aneurysm while the other 3 patients presented AEF after aortic surgery.All 6 patients showed he-matemesis,among whom 3 presented sentinel hemorrhage,1 presented exsanguination after sentinel hemor-rhage,2 presented sudden exsanguination.Among 4 patients with sentinel hemorrhage,2 accompanied with chest pain,1 with dysphagia and 1 with fever.Two patients had a history of hypertension.Diagnostic rate was nearly 100% by gastroscopy or CT/CTA.Four patients died from hemorrhagic shock and 2 patients re-covered from surgery.Conclusion AEF should be seriously considered for patients with a history of hyper-tension,aortic disease or esophageal foreign body presenting sentinel hemorrhage,chest pain,dysphagia,fa-tal exsanguination followed by symptom-free interval.Prompt examinations and aggressive surgery are of great significance for survival.