髓周动静脉瘘的诊断及手术治疗  

Diagnosis and microsurgery for perimedullary arteriovenous fistulas

作　　者：李桃[1] 王汉东[1] 杭春华[1] 纪祥军[1] 刘炎[1] 茅磊[1] 

机构地区：[1]南京大学医学院附属金陵医院(南京军区南京总医院)神经外科,210002

出　　处：《中国微侵袭神经外科杂志》2017年第7期312-314,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：江苏省自然科学基金青年基金(编号:BK20140731)

摘　　要：目的探讨髓周动静脉瘘(perimedullary arteriovenous fistulas,PMAVF)的诊断及显微手术治疗。方法回顾性分析采用显微手术治疗的10例PMAVF病人的临床资料,分析CTA检查在PMAVF中的应用价值及显微手术对脊髓功能的影响。结果 8例病人CTA与DSA诊断完全一致,且CTA在判定瘘口方面也与DSA相同,1例CTA检查阴性病例后经DSA检查明确诊断为PMAVF,1例病人术前仅行DSA检查。术后所有病人复查DSA示瘘口无再通,随访6个月~2年,症状改善7例,稳定2例,加重1例。术后6个月病人Aminoff-Logue评分明显优于术前(P<0.05)。结论显微手术是治疗PMAVF的有效方法 ,早期诊断和治疗对病人下肢运动及大小便功能的改善非常重要。Objective To analyze the diag nosis and microsurgery for patients with perimedullary arteriovenous fistulas （PMAVF）. Methods Clinical data of 10 PMAVF patients undergoing microsurgery were analyzed retrospectively. Application value of CTA in PMAVF and the influence of microsurgery on spinal cord function were analyzed. Results The CTA results were identical with DSA results in 8 patients, and the CTA was same to DSA in determining the fistulas of PMAVF. There was 1 patient with negative CTA examination result, who was definitly diagnosed with PMAVF by DSA. One patient received only DSA examination before surgery. Postoperative spinal DSA reexamination showed that no fistula recanalization occurred in all the patients. All the patients were followed up for 6 month to 2 years and the spinal function was improved in 7, stable in 2 and aggravated in 1 patient. The Aminoff-Logue Scoring 6 months after surgery was significantly superior to preoperation （P〈 0.05）. Conclusions Microsurgery is an effective method for PMAVF. The early diagnosis and treatment could improve the lower limb motor and sphincter functions.

关 键 词：髓周动静脉瘘 动静脉畸形 脊髓 脊髓功能 CT血管成像 

分 类 号：R651.2[医药卫生—外科学]