“拔管-注射”技术栓塞小型脑动静脉畸形的研究  

Research on "pulling-injection technology" embolization for small arteriovenous malformations

作　　者：张红彬[1,2] 姜鹏[1] 江裕华[1] 李佑祥[1] 

机构地区：[1]北京市神经外科研究所北京市神经介入工程中心首都医科大学附属北京天坛医院神经介入科,100050 [2]北京市房山区第一医院神经外科,102400

出　　处：《中国微侵袭神经外科杂志》2016年第5期205-207,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的总结"拔管-注射"技术(PIT)栓塞直径≤3 cm脑动静脉畸形(AVM)的治疗经验。方法 20例应用Onyx栓塞且直径≤3 cm的脑AVM,病例按照随机数字表法分为两组:对照组和实验组,每组10例。对照组采用"Hold-Reinjection"技术,间断注射Onyx,等待近端"Onyx塞子"建立。实验组采用"拔管-注射技术"压缩Onyx铸型团建立"塞子"后注射Onyx。比较两组病人年龄、性别、始发症状、畸形团位置、是否合并动脉瘤及硬脑膜动静脉瘘、Spetzler-Martin分级和供血动脉支数。术后即时造影效果按完全栓塞、近全栓塞(≥90%体积)、部分栓塞分级,对两组病人栓塞效果进行统计学分析。结果术后即时造影显示实验组栓塞效果明显好于对照组,单次栓塞治愈率较对照组明显增高,分别为80%、20%,两组间差异有统计学意义(P<0.05)。结论 "拔管-注射"技术可显著提高Onyx对直径≤3 cm脑AVM的单根供血动脉单次栓塞治愈率。Objective To summarize the treatment experience with ＂pulling-injection technology＂ embolization for less than 3 cm cerebral arteriovenous malformation（AVM）. Methods There were 20 patients with less than 3 cm cerebral AVM undergoing Onyx embolization. All the patients were randomly divided into control group and experimental group, 10 in each group. The control group received intermittent injection of Onyx using ＂Hold-Reinjection technology＂, waiting for establishment of the proximal Onyx plug. In the experimental group, the ＂pulling-injection technology＂ was adopted for establishing the pedical proximal Onyx plug quickly. The age,sex, initial symptoms, malformation location, complicated aneurysms and dural arteriovenous fistula, Spetzler-Martin grade and number of feeding artery of the patients were compared between the two groups. All the patients were classified by complete embolization,near-complete embolization（≥90% volume） and partial embolization in the immediate postoperative angiography, and the effect of embolization was statistically analyzed in the two groups. Results The embolization effect was significantly better in the experimental group than in the control group. The cure rate was 80% in the experimental group, which was much higher than that of the control group（20%, P〈0.05）. Conclusionds The ＂pulling-injection technology＂ can significantly improve the cure rate of Onyx for cerebral AVM less than 3 cm in a single embolization through a single feeding artery.

关 键 词：颅内动静脉畸形 血管内治疗 栓塞 “拔管-注射”技术 

分 类 号：R651.12[医药卫生—外科学]