血管内栓塞与显微外科手术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：高鸿[1] 苏平[1] 孙敏[1] 彭远[1] 惠金明[1] 谷震[1] 张明[1] 刘俊[1] 马钢[1] 李俊彦[1] 

机构地区：[1]昆明市第一人民医院神经外科

出　　处：《中华显微外科杂志》1999年第3期189-191,共3页Chinese Journal of Microsurgery

基　　金：云南省青年科研基金

摘　　要：目的为了提高巨大脑动静脉畸形（ＡＶＭ）的治疗效果，降低致残率及死亡率。方法术前用α－氰基丙烯酸正丁酯（ＮＢＣＡ）或丝线段行一次或多次血管内栓塞治疗，使脑动静脉畸形的血管床缩小到５０％～８０％，于栓塞后３～１５天行手术全切除。结果２６例巨大脑动静脉畸形栓塞后手术全切除，无术后死亡及术后手术区再发血肿发生，２６例病例中４例有神经功能障碍，７例术中皮质脑电图监测后行软膜下病灶切除术的病人未再发生癫痫。结论血管内栓塞与手术联合是治疗巨大脑ＡＶＭ的有效方法，术中皮质脑电图监测下切除痫灶是消除术后癫痫再发的手段。Objective To improve treatment effect of giant cerebral AVM and reduce mortality and rate of deformity Methods Before operation,one or many times embolization were made using NBCA or thread piece to reduce bed of blood vessel of AVM to 50%～80%,then resection of AVMS were made 3～5 days after embolization Results All of 26 patients were survived after operation,and there were no resend haematoma in operation region, 4 of them had transient neurologicl deficits, 7 of them have no epilepsic seizure after resecting subpiamater epilepsic focus under cortex electroencephologram monitoring Conclusion Combination of intraoperative embolization with surgical resection is an effective way in the treatment of giant cerebral AVM and it is a effective measure to delete resend epilepsy by resecting subpiamater epilepsic focus under cortex electroencephologram monitoring

关 键 词：脑动静脉畸形 血管内栓塞 显微外科手术 

分 类 号：R743.405[医药卫生—神经病学与精神病学]