圆锥动静脉畸形的栓塞和手术治疗  

Endovascular and surgical treatments of conus medullaris arteriovenous malformations

作　　者：陈亚坤[1] 齐向前[1] 梅其勇[1] 李一明[1] 韩凯伟[1] 吕立权[1] 黄承光[1] 白如林[1] 侯立军[1] 

机构地区：[1]第二军医大学附属长征医院神经外科上海市神经外科研究所中国人民解放军神经外科研究所,200003

出　　处：《中国微侵袭神经外科杂志》2015年第10期433-436,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然科学基金(编号:81171130)

摘　　要：目的总结圆锥动静脉畸形的栓塞和手术治疗经验。方法回顾性分析26例圆锥动静脉畸形的临床资料,采用改良Aminoff-Logue评分评价手术前后脊髓功能改变情况。结果保守观察3例;外科治疗23例,其中单纯栓塞9例,先栓塞后手术5例,单纯手术9例。随访18例,时间3~60个月,平均13.0个月,13例症状不同程度好转,3例症状保持稳定,2例加重。术后改良Aminoff-Logue功能评分较术前显著改善（P=0.001）。结论圆锥动静脉畸形治疗存在挑战,对合适病例采取栓塞、手术或联合方法有较好疗效,强调早期治疗。Objective To summarize the experience in the endovascular and surgical treatment of conus medullaris arteriovenous malformations（c AVM）. Methods The clinical data of 26 patients with c AVM were analyzed retrospectively. The pre- and postoperative spinal cord functions were evaluated by the Aminoff-Logue Score. Results Conservative treatment was given in 3 patients.Surgical treatment was conducted in 23 patients, including embolization alone in 9 patients, embolization followed by microsurgical resection in 5 and microsurgical resection alone in 9. Eighteen patients were followed up for 3-60 months, an average of 13 months,neurologically improved in 13 patients, stable in 3 and worsened in 2. A significant improvement in Aminoff-Logue Score was observed in the follow-up patients（P = 0.001）. Conclusions Although c AVM is challenging to treat, an excellent outcome can be achieved with a combined endovascular and microsurgical approach. The importance of early treatment should be underscored.

关 键 词：动静脉畸形 圆锥 血管造影术 栓塞 治疗性 神经外科手术 

分 类 号：R651.1[医药卫生—外科学]