颅内动脉瘤合并动静脉畸形的治疗策略  

Treatment strategy of intracranial aneurysm complicated with arteriovenous malformation

作　　者：陈川[1] 黄振超[1] 龚瑾[1] 叶卓鹏[1] 王辉[1] 

机构地区：[1]中山大学附属第三医院神经外科,广东广州510630

出　　处：《海南医学》2012年第19期55-58,共4页Hainan Medical Journal

基　　金：国家自然科学基金(编号:30901542)

摘　　要：目的初步探讨颅内动脉瘤合并动静脉畸形的治疗策略。方法对2005年8月到2010年3月间收治的5例颅内动脉瘤合并动静脉畸形病例的临床分类、治疗方法及结果进行回顾性分析。结果全组病例均经全脑数字减影血管造影(DSA)检查确诊,包括AVM团内型1例,AVM血流相关型2例,AVM无关型2例。2例患者一期手术夹闭责任动脉瘤并同时切除AVM,1例栓塞动脉瘤后二期手术切除AVM,1例患者栓塞动脉瘤后,二期伽马刀治疗丘脑AVM,另1例手术切除AVM病灶,二期手术夹闭动脉瘤。5例病例复查DSA均未见动脉瘤或畸形血管团残留。结论此类病例中,动脉瘤与动静脉畸形的解剖特点和构筑关系往往比较复杂。针对不同临床特点的病例,应采取合理的个体化治疗策略,以得到理想的疗效。Objective To investigate the treatment strategy for intraeranial aneurysm complicated with arte- riovenous malformation （AVM）. Methods The clinical data of five patients of intracranial aneurysm complicated with AVM admitted in our hospital from August 2005 to march 2010 were retrospectively analyzed, including the clas- sification, treatment and outcome. Results All the patients were confirmed by DSA, composed by 1 case ofintranidal type, 2 cases of flow-related type and 2 cases of unrelated type. In two patients, the aneurysm and AVM were clipped and surgically removed in one phase. In one patient, the incision of AVM was secondary to the coiling of aneurysm. In one patient, a coiling of aneurysm was succeeded by knife for AVM in thalamus. In one patient, clipping of aneurysm was carried out after incision of AVM in the second phase. No residual aneurysm or AVM was visualized by DSA after systematically treatment. Conclusion Aneurysm with AVIVI always has complex anatomic features and angio-architee- rural relationships. Reasonable individual treatment strategies should be taken to achieve reliable clinical outcomes.

关 键 词：颅内动脉瘤 动静脉畸形 治疗 

分 类 号：R732.21[医药卫生—肿瘤]