破裂出血的脑动静脉畸形急症治疗  

Emergency operation of intracerebral hemorrhage due to rupture of cerebral arteriovenous malformation.

作　　者：鲍洪[1] 吴开华[1] 丁轩[1] 招建华[1] 兰蒙[1] 

机构地区：[1]暨南大学医学院附属第三医院

出　　处：《中国热带医学》2005年第4期801-802,804,共3页China Tropical Medicine

摘　　要：目的探讨脑动静脉畸形(cAVM)并出血的急诊手术疗效。方法32例脑出血的病人行急诊清除血肿手术,幕上30例,幕下2例,18例切除畸形血管团(2例合并动脉瘤),6例行部分切除或血管夹闭。结果术中发现cAVM24例,术后病理证实cAVM29例。2例血肿复发,再次手术。2例死亡(6.3%)。30例6个月-24月后随访,日常生活能力评价:Ⅰ级14例(46.7%),Ⅱ级10例(33.3%),Ⅲ级4例(13.3%),Ⅳ级2例(6.7%)。结论急诊手术清除血肿并尽切除小型cAVM是治疗cAVM并出血的的首选方法,疗效明显。Objective Explore the effect of hemorrhage from cerebral artefiovenous malformations （cAVM） treated by emergency operation Methods 32 patients suffered from intracerebral hemorrhage were removed hematom by emergency operation（30 cases supratentofial,2 cases infratentorial）. The cAVM in 18cases were total resected（2 cases accomplanied with aneurysms） , in 6 cases partly resected or ligated bleeding vessels. Results The cAVM was found in 24 patients.29 patients were confirmed having cAVM by pathologica study postoperation. Rebleeding occurred to in 2 patients, and second operation was performed and 2 patients were died （6.3 % ） .30 patients were followed up for 6 months to 24 months postoperation, whose living quality of activity of daily living demonstrated that 14 cases in grade Ⅰ （46.7%）, 10 cases in grade Ⅱ （33.3%）, 4 cases in grade Ⅲ（ 13.3% ）,2 cases in grade （6.7%）. Conclusion It is the first choice to remove hamatom by emergency operation and to resect smaller cAVM for dealing with intracerebral hemorrhage due to rupture of arteriovenous malformation and good clinical results can be achieved.

关 键 词：脑动静脉畸形 出血 手术 

分 类 号：R743.4[医药卫生—神经病学与精神病学]