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本文复习了1973年10月至1996年5月Mayo医疗中心收治的109例破裂的巨大动脉瘤病例,占所有巨大动脉瘤病例数的25％,占经手术治疗的动脉瘤病例数的5％。平均发病年龄为52岁(18周岁～81岁),多数病例60～70岁为高发,男女比例为1:2,35％患者有高血压史,109例破裂的巨大动脉瘤直径为25～60mm。其中81例(74％)位于前循环,28例(26％)位于后循环。好发部位首推颈内动脉(ICA)床旁段(30例,占28％),其次为大脑中动脉(28例,占26％)。分叶状动脉瘤存在于7％的患者,39％的病例有不同程度的瘤内血栓形成。106例为单发巨大动脉瘤,3例为双侧对称性巨大动脉瘤。17％为巨大动脉瘸与非巨大动脉瘤并存。109例患者中,31例(28％)发生了不同程度再出血,25例发生再次出血,4例发生两次再出血,2例发生三次再出血,首次出血与再出血的时间间隔为15天内。
This article reviews 109 cases of ruptured giant aneurysms treated at the Mayo Clinic from October 1973 to May 1996, accounting for 25% of all cases of giant aneurysms and 5% of the surgically treated aneurysms. The average age of onset was 52 years old (18 years old to 81 years old). Most cases were high incidence of 60 to 70 years old. The ratio of male to female was 1: 2,35%. The history of hypertension was 109 cases. The diameter of 109 cases with ruptured giant aneurysms was 25-60 mm . Of these, 81 (74%) were in the anterior circulation and 28 (26%) were in the posterior circulation. The best site of internal carotid artery (ICA) bedside segment (30 cases, 28%), followed by the middle cerebral artery (28 cases, 26%). Lobed aneurysms are present in 7% of patients, and 39% have varying degrees of intratumoral thrombosis. 106 cases of giant aneurysms, and 3 cases of bilateral symmetrical giant aneurysms. 17% of giant artery lame and non-giant aneurysm co-exist. Among the 109 patients, 31 (28%) had various degrees of rebleeding, 25 had hemorrhage again, 4 had two rebleeds, 2 had three rebleeds, and the interval between first and second rebleeding was 15 days .