颅内动静脉畸形显微外科手术治疗的方法与效果  

Analysis the effect of intracranial arteriovenous malformation(AVM) method of microsurgical operation

作　　者：曲艺[1] 牟壮 朱健[1] 

机构地区：[1]齐齐哈尔市第一医院神经外二科,黑龙江齐齐哈尔161005

出　　处：《临床和实验医学杂志》2015年第9期707-710,共4页Journal of Clinical and Experimental Medicine

基　　金：黑龙江省教育厅科学技术研究项目(编号:12531796)

摘　　要：目的：探讨颅内动静脉畸形（AVM）显微外科手术治疗方法和临床效果。方法选取手术治疗的90例颅内动静脉畸形患者，随机将其分为两组。对照组患者实行显微开颅切除手术，实验组患者实行显微下开颅切除手术联合术前栓塞术。比较两组患者的临床疗效、术后不良反应以及生活质量改善情况。结果实验组Ⅲ-Ⅴ级患者出血量显著低于对照组，Ⅲ级和Ⅳ级患者的完全切除率分别为90.00%、72.73%显著高于对照组的52.38%、45.45%，实验组Ⅲ-Ⅴ级 GOS评分显著高于对照组；实验组患者术后偏瘫（8.89%）、偏盲（4.45%）、脑神经功能障碍（2.22%）、癫痫（4.45%）的发生率显著低于对照组患者术后偏瘫（33.33%）、偏盲（28.89%）、脑神经功能障碍（22.22%）、癫痫（4.45%）的发生率；实验组患者的躯体功能、生理职能、身体疼痛以及总体健康评分显著高于对照组患者，差异均具有统计学意义（ P 〈0.05）。结论显微开颅手术与栓塞术的联合治疗颅内动静脉畸形可以有效改善临床效果，降低不良反应的发生，提高患者的生活质量。Objective To analyze the intracranial arteriovenous malformation（AVM）micro surgical operation treatment method and clinical effect. Methods 90 cases of intracranial venous malformation were included into this study. All patients received operation treatment in our hospi-tal. All patients were grouped according to the method of treatment,patients in the control group received microsurgical resection operation,patients in the control group under the implementation of micro craniotomy for operation combined with preoperative embolization. The clinical effect was com-pared between two groups of patients,and including postoperative adverse reactions and the improvement of the quality of life. Results The bleeding volume in experimental group III - V level patients was significantly lower than the control group. The patients with completely resected III and IV rates were completely removed in 90. 00% ,72. 73% ,which were significantly higher than that of control group III and IV patients rate respectively is 52. 38% ,45. 45% . III - V grade GOS scores were significantly higher than that of the control group. The patients of experiment groups with hemi-plegia（8. 89% ）,hemianopia（4. 45% ）,cranial nerve dysfunction（2. 22% ）,epilepsy（4. 45% ）was significantly lower than those in control group,the incidence of postoperative patients with hemiplegia（33. 33% ）,hemianopia（28. 89% ）,cranial nerve dysfunction（22. 22% ）,the inci-dence of epilepsy（4. 45% ）. The physical function,role physical,bodily pain,general health scores in the patients in the experimental group were significantly higher than that of the control group of patients,the difference was statistically significant（ P 〈 0. 05）. Conclusion The combined treatment of micro craniotomy and embolization can effectively improve the clinical effect and reduce the occurrence of adverse reactions and improve the quality of life of patients,and has important application value in clinic.

关 键 词：颅内动静脉畸形 显微外科 手术方法 临床疗效 

分 类 号：R651.12[医药卫生—外科学]