硬脊膜动-静脉瘘9例的诊断及治疗  

Diagnosis and treatment of 9 cases with spinal dural arteriovenous fistulas

作　　者：吴伟[1] 戴嵬[1] 成惠林[1] 张鑫[1] 张庆荣[1] 王汉东[1] 杭春华[1] 史继新[1] 

机构地区：[1]南京军区南京总医院神经外科,江苏省210002

出　　处：《江苏医药》2013年第10期1160-1162,I0001,共4页Jiangsu Medical Journal

摘　　要：目的总结硬脊膜动-静脉瘘的临床诊治经验。方法回顾性分析9例硬脊膜动-静脉瘘患者的临床资料。结果本组患者经半或次全椎板切除入路手术6例,经血管内栓塞3例。6例手术患者术后复查脊髓血管造影显示瘘口完全闭塞。3例栓塞者复查脊髓MRI示髓周血管流空信号影全部消失。8例患者获随访3个月-5年,4例患者症状完全消失,3例改善,1例加重,所有随访患者复查DSA示瘘口无再通。结论硬脊膜动-静脉瘘起病隐匿,易漏诊、误诊,自然病程预后差,应积极干预,疗效理想。Objective To summarize the experience in surgical treatment of spinal dural arteriovenous fistula（SDAVF）. Methods The clinical and following-up date from 9 patients with SDAVF were analyzed retrospectively. Results Draining vein between fistula and spinal cord was interrupted by hemilaminectomy or subtotal laminectomy approach in 6 patients and by endovascular emholization in 3. Complete disappearance of SDAVF was confirmed in 6 surgical patients who received postoperative spinal angiography. The paramedullary tortuous flow voids fully disappeared in all patients on postoperative T2 weighted MRI. The patients were followed up for 3 months to 5 years, which showed a complete recovery in 4 patients, improvement in 3 cases, and deterioration in 1 case. All patients were no recurrence during follow up. Conclusion SDAVF is insidious in onset, which is easily misdiagnosed and has a poor prognosis without treatment. Early treatment can produce a good outcome.

关 键 词：动-静脉瘘 脊髓 

分 类 号：R332[医药卫生—人体生理学]