栓塞与手术切除联合治疗巨大脑动静脉畸形  

Combination of intraoperative embolization with surgical resection for treatment of giant cerebral AVMs

作　　者：赵继宗[1] 王忠诚[1] 王硕[1] 李京生[1] 李忠[1] 

机构地区：[1]北京天坛医院神经外科

出　　处：《中华神经外科杂志》1997年第1期6-8,共3页Chinese Journal of Neurosurgery

基　　金：卫生部"九五"攻关课题

摘　　要：目的：为防止正常灌注压突破综合症，解决巨大脑动静脉畸形（直径＞６．０ｃｍ）手术切除的困难，降低手术死亡率。方法：术中首先分次结扎供应动脉近端，注入ＩＢＣＡ１．０ｍｌ＋５％葡萄糖１ｍｌ。分离畸形血管团，最后将其全切。术后常规复查脑血管造影。结果：２６例巨大ＡＶＭ′ｓ栓塞后手术全切，无手术死亡。术后短期神经功能缺损加重７例，随访６～３６月（平均１９．５月），２４例恢复正常工作和学习。结论：栓塞与手术切除联合治疗巨大动静脉畸形是治疗巨大动静脉畸形的有效手段。Objective: To reduce the difficulty of surgical resection of giant AVMs and prevent normal perfusion pressure breakthrough (NPPB), and diminish the postoperative mortality. Methods: The proximal end of the feeding arteries were ligated first, and 1 0ml IBCA mixed with 1 5ml 5% Glucose were injected into the nidus, then the lesions were resected completely. Post operative digital subtraction angiography (DSA) were done routinely. Results: All of 26 patients were survived after operation. 7 of them (26 9%) had transient neurological deficits and 24 patients (92 3%) had recovered in follow up 6 36 months. Conclusion: Combination of intraoperative embolization with surgical resection is an effective way in the treatment of giant cerebral AVMs.

关 键 词：动静脉畸形 外科手术 栓塞术 

分 类 号：R743.405[医药卫生—神经病学与精神病学]