摘要
目的探讨脑动静脉畸形（AVM）的临床治疗方法。方法回顾性分析2010年2月至2013年10月收治的123例脑AVM患者的临床资料。显微手术治疗70例,血管内治疗53例。结果手术治疗70例中,病灶完全切除61例;小部分残留患者9例,其中7例行伽玛刀治疗;术后随访3个月至2年,按GOS评分：恢复良好59例,中残6例,重残3例,植物生存1例,死亡1例。栓塞治疗53例中,一次完全栓塞21例;分次完全栓塞25例;小部分残留7例,行伽玛刀治疗;术后随访3个月-2年,按GOS评分：恢复良好48例,中残3例,植物生存1例,死亡1例。结论显微手术是脑AVM最主要的治疗方法;血管内栓塞既可以单独用于治疗,又可以作为显微手术重要辅助手段;病灶体积较大、位置在功能区或结构复杂的脑AVM常需要联合治疗。
Objective To explore the treatment strategy of cerebral arteriovenous malformations （AVMs）. Methods The clinical data of 123 patients with cerebral AVMs, of whom, 70 underwent microsurgery and 53 were treated by endovaseular embolization in recent 4 years, were analyzed respectively. According to Spetzler-Martin grading, of 123 cases of AVMs, 44 belonged in grades Ⅰ-Ⅱ, 35 in grade Ⅲ, 28 in grade Ⅳ, and 16 in grade V. The prognoses were assessed by GOS in all the patients. Results Of 70 patients with AVMs undergoing microsurgery, 61 received total resection of AVMs, and 9 subtotal and had residual AVMs. Gamma knife was performed in 7 of 9 patients with residual AVMs. The following-up from 3 months to 2 years showed that of 70 patients undergoing the microsurgery, 59 were recovered well, 5 mildly disabled, 3 moderately disable, 1 severely disabled 1 survived vegetatively and 1 died. Of 53 patients treated by endovaseular embolization, 21 received total obliteration of AVMs by one embolization, 25 received total obliteration of AVMs which were embolized by stages and 7 had residual AVMs, which were treated by gamma knife after the operation. Of 53 patients treated by endovascular embolization, 48 were recovered well, 3 were mildly disabled, 1 survived vgetatively and 1 died. Conclusions Microsurgery is a main method to treat cerebral AVMs. The endovascular with embolization is another choice for AVMs. The huge or complex AVMs may be treated by microsurgery combined endovascular embolization.
出处
《中国临床神经外科杂志》
2014年第10期581-583,共3页
Chinese Journal of Clinical Neurosurgery
关键词
脑动静脉畸形
显微手术
血管内栓塞
Intracranial arteriovenous malformation
Microsurgery
Endovascular embolization
Combined therapy
