Onyx介入栓塞联合显微手术切除脑动静脉畸形的临床应用  

Clinical application of the multimodality treatment of brain arteriovenous malformation with Onyx embolization and microsurgery

作　　者：郭少雷[1] 齐铁伟[1] 梁丰[1] 王凌雁[1] 何科君[1] 杨毅兵 黄正松[1] 

机构地区：[1]中山大学附属第一医院神经外科,广州510080

出　　处：《中华显微外科杂志》2014年第3期250-253,共4页Chinese Journal of Microsurgery

基　　金：国家自然科学基金项目（81171102）

摘　　要：目的评价Onyx介入栓塞联合显微手术治疗脑动静脉畸形（BAVM）的临床应用价值。方法应用Onyx血管内介入栓塞联合显微手术治疗48例BAVM，记录病例的临床特征、治疗经过和相关并发症，出院前复查MRI和DSA，GOS预后量表评估出院情况；随访采用改良Rankin评分（mRS）评价预后。结果手术全切除47例（97．9％），发生治疗相关并发症8例（16．7％）：神经功能损伤4例（8．3％），包括2例肢体运动功能障碍、1例运动性失语和1例明显的视野缺损；术后出血2例（4．2％）；严重脑水肿2例（4．2％）；其余40例（83．3％）患者治疗后情况比入院时改善或持平。出院的GOS评分恢复良好38例（79．2％）；随访6—42个月的mRS评分小于3分47例（97．9％）。结论Onyx介入栓塞联合显微手术切除BAVM可以取得理想的临床疗效。Objective To evaluate the clinical application of muhimodality treatment of brain arteriovenous malformation （BAVM） with Onyx embolization and microsurgery. Methods There were 48 patients with BAVM treated by combination of Onyx embolization and microsurgery. The clinical features, therapeutic process, complications and discharge status （by MRI, DSA and Glasgow outcome scale, GOS） were recorded in detail. The prognosis was estimated by modified Rankin scale （mRS） with 6-42 months＇ follow-up. Results The total resection rate was 97. 9%. The therapy-related complications happened in 8 patients （ 16. 7% ）. Among them, 4 cases had dysfunction of central nervous system （8. 3% ）, 2 cases with intra-cerebral hemorrhage （4. 2% ）, and 2 suffered from severe cerebral edema （4. 2% ）. Good recovery was seen in 38 cases （79. 2% ） evaluated by GOS when discharged from hospital. The follow-up result mRS 〈 3 was 97. 9%. Conclusion Muhimodality treatment of BAVM with Onyx embolization and microsurgery should be a good therapeutic strategy.

关 键 词：脑动静脉畸形 ONYX 栓塞 显微外科手术 

分 类 号：R651.12[医药卫生—外科学]