Schmid P, Parsché P, Höfler H, Hofmann H
Wien Med Wochenschr. 1983 Apr 30;133(8):207-11.
On the basis of a large autoptic material (67,352 autopsies between 1948 and 1978), clinical symptoms, diagnosis and pathologic anatomy of 140 non-aortal aneurysms (except cerebral basal arterial aneurysms) are presented. There was an accumulation beyond the 5th decade of age, among the etiologic factors atherosclerosis was predominant. 65 percent of the cases were men, 35 percent were women. Diagnosis during life time was only achieved in 16 cases (11.5 percent): in 6 cases by palpation and/or auscultation, in 4 cases by angiography, in 3 cases by an incidental intraoperative finding, in 2 cases by the help of an X-ray survey and in one case by sonography. The main reason for this low percentage of intravitally diagnosed aneurysms has to be sought in the poverty or the complete lack of clinical symptoms. If there are clinical symptoms, these are most frequently caused by a thrombosis of the aneurysm with a consecutive disturbance of arterial perfusion, and less frequently by a rupture of the aneurysm with or without compression of adjacent organs. The prerequisite for a more frequent and earlier intravital diagnosis is the inclusion of an aneurysm into differential diagnostic thinking, especially in elderly patients and unclear clinical symptomatology.
基于大量尸检材料(1948年至1978年间67352例尸检),本文介绍了140例非主动脉瘤(脑基底动脉动脉瘤除外)的临床症状、诊断及病理解剖情况。发病年龄多在50岁以后,病因以动脉粥样硬化为主。病例中男性占65%,女性占35%。生前仅16例(11.5%)得以诊断:6例通过触诊和/或听诊,4例通过血管造影,3例通过术中偶然发现,2例借助X线检查,1例通过超声检查。动脉瘤生前诊断率低的主要原因在于临床症状缺乏或完全没有。若有临床症状,最常见的原因是动脉瘤血栓形成继而导致动脉灌注紊乱,较少见的原因是动脉瘤破裂,伴或不伴有邻近器官受压。更频繁、更早地进行生前诊断的前提是将动脉瘤纳入鉴别诊断思路,尤其是在老年患者和临床表现不明确的情况下。