脑动静脉畸形治疗方法选择(附36例报告)  

Study on choice of treatment of Cerebral Arteriovenous Malformation: a review of 36 cases.

作　　者：丁轩[1] 鲍洪[1] 吴开华[1] 招建华[1] 兰蒙[1] 骆太顺[1] 

机构地区：[1]暨南大学医学院第三附属医院广东省珠海市人民医院神经外科,广东珠海519000

出　　处：《中国热带医学》2005年第4期793-795,共3页China Tropical Medicine

摘　　要：目的探讨各种类型脑动静脉畸形(AVM)治疗方法的选择为临床治疗提供依据。方法对36例脑AVM临床治疗进行回顾性分析,并结合文献复习。结果36例脑AVM病人,手术切除9例和血管内栓塞后手术切除2例畸形血管团消失,γ-刀治疗4例,复查血管团消失或染色变淡,血管内栓塞10例和血管内栓塞后γ-刀治疗11例中栓塞>95%4例,>80%7例,>50%8例。复查GOS预后分级5级25例(69.4%);4级7例(19,4%),其中后遗头痛3例,癫痫4例;3级3例(8.3%)后遗神经功能缺失,主要为偏瘫、失语等;死亡1例(2.8%)。结论根据脑AVM的Spetzler-Martin分级和临床类型选择合理的治疗方法可减少致残率和病死率。Objective To analyze the choice of treatment of Cerebral Arteriovenous Malformation（AVM）. Methods Clinical data obtained from 36 patients with AVM treated by three methods were analyzed retrospectively, and reviewed with literatures of 36 AVM cases, 9 cases treated with operating excision, 10 cases treated with endovascular embolization ,4 cases treated with the gamma knife（ γ- knife） ,2 cases treated with operating excision after endovascular embolizations, 11 cases treated with gamma knife after endovascular embolizations. Results Of 36 patients, angiography showed disappearance of AVM nidus in 8 cases of microsurgery and 11 cases of operating excision after endovascular embolizations; Reexamination of 4 cases treated by γ- knife showed the AVM nidus disappearance or reduced; for 10 cases of endovascular embolization and 11 cases of T - knife after endovascular embolizations, Complete embolization （ 〉 95%）was done in 4 cases, 〉 80% in 7 cases, 〉 50% in 8 cases. In follow - up, there were 25 cases（69. 4%） in GOS grade 5; 7 cases（19.4%） in grade 4,thereinto, 3 cases had headache left, 4 cases had epilepsies left; 3 cases（8. 3 % ） in grade 3 which had dysfuntion of nerve system left, such as hemiplepsy, aphasia, et al; 1 case（2.8 % ） had died. Conclusion Choosing right method to cure cAVM according to its Spetzler- Martin classification and clinic type can decrease deformity rate and mortality.

关 键 词：脑动静脉嘲形 手术 血管内拴塞 放射外科 

分 类 号：R743.4[医药卫生—神经病学与精神病学]