摘要
目的:探讨脑动静脉畸形(AVM)治疗中显微手术、放射外科治疗及血管内介入治疗的选择。方法:对1996年1月-2003年1月问我科收治的157例脑AVM按S-M分级进行分析,Ⅰ级22例,Ⅱ级53例,Ⅲ级59例,Ⅳ级23例。显徼手术72例,镜下AVM全切除61例,输入动脉切断术11例;X-刀39例,其中8例由于再次出血手术治疗;血管内介入治疗46例,其中9例残余血管另行X刀治疗、13例介入治疗后行手术治疗。所有患者均经随访1-8年。结果:术后因并发症死亡2例,手术切除后59例经造影复查AVM消失,余11例补充行X刀治疗;X刀治疗8例再次行手术治疗,余31例半年后复查,畸形血管团缩小,2年后复查13例完全消失,18例缩小50%以上;单纯介入治疗11例完全消失,13例缩小50%以上;介入治疗后再行手术治疗或X刀者22例,2年后复查畸形团均消失。全组病例恢复原工作或轻体力劳动者126例,生活自理29例。结论:显微外科手术仍是治疗脑AVM的主要方法,放射外科治疗和介入治疗对于不适合或不能接受手术者也是行之有效的方法,与手术结合的方法可取得更好的疗效。
Objective: Discussing the treatment methods for cerebral arteriovenous malformation (AVM) . Method: 157 patients taking AVM were analized from January of 1996 to 2003, in according to Spetzler - Martin (S - M) grade. 72 patients were treated with microsurgery resection, 39 patients were treated with X - knife, and the other 46 patients were treated with intravescu-lar embolization. All patients were followed up for 1 to 8 years. Resorts: 2 patients died from complication. In operation group, AVM of 59 patients disappeared, and the other 11 patients were treated with X - Knife additionally. In X - Knife group, 31 AVM shrinked half year after treatment, 13 disappeared and 18 shrinked more than 50% ; the other 8 were taken microsurgery. In intrav-escular embolization group, 11 disappeared and 13 shrinked more than 50%, 22 were treated with microsurgery or X - Knife after in-travescular embolization. 2 years later, All of the 46 AVM disappeared. The clinical symptoms of all patients showed good recovery in 126 cases, and moderate disability in 29 cases. Conclusion: Microsurgery is the major method for treating cerebral AVM, the X -Knife and intravescular embolization are also effective methods for patients not fitting operation. The combination of operation with other methods would take more effects.
出处
《福州总医院学报》
2004年第3期158-159,共2页
Journal of Fuzhou General Hospital
