硬脊膜动静脉瘘的临床特点和治疗现状  

Clinical Features and Treatment Status of Spinal Dural Arteriovenous Fistula

作　　者：王刚[1] 佟志勇[1] 刘源[1] 温志锋[1] 潘起晨[1] 梁传声[1] 

机构地区：[1]中国医科大学附属第一医院神经外科,沈阳110001

出　　处：《医学综述》2018年第3期527-532,共6页Medical Recapitulate

基　　金：国家重点研发计划(2016YFC1300802)

摘　　要：硬脊膜动静脉瘘(SDAVF)是一种临床表现不典型的罕见疾病,脊髓数字减影血管造影是其诊断的金标准。近年来,以脊髓磁共振血管成像、CT血管成像为代表的无创/微创血管成像技术在协助诊断SDAVF方面取得了很大进展。该病自然转归较差,如果未经有效治疗,其症状将呈波动性加重,最终可导致永久性的脊髓损伤。因此一旦确诊,应尽早采取合适的治疗,以阻断疾病进展。SDAVF的治疗方式主要包括显微外科手术和血管内介入治疗。随着医疗技术的进步,两种治疗方式均较以往取得较大进展,手术治疗准确性更高、创伤更小、效果更好。未来在临床实践中,应力争早期正确诊断SDAVF,并根据病情灵活选择和运用各种治疗方式。Spinal dural arteriovenous fistula（ SDAVF） is a rare disease with diverse clinical presentations. Spinal digital subtraction angiography is the gold standard for the diagnosis. In recent years,minimally invasive/noninvasive angiography,represented by magnetic resonance angiography of the spinal cord and CT angiography,have made great progress in diagnosis of SDAVF. The natural prognosis of the disease is poor. If no effective treatment is given,the symptoms show fluctuating aggravation,which may eventually lead to a permanent spinal cord injury. Therefore,once the diagnosis is confirmed,appropriate treatment should be given as soon as possible in order to block the progress of the disease. The treatment of SDAVF mainly includes microsurgery and intravascular interventional therapy. With advances in medical technology,more progress has been made in the two ways of treatment. The surgical treatment is more accurate,less traumatic and has better effect. In the future clinical practice,we should strive for early and correct diagnosis of SDAVF,and choose and use various treatment methods flexibly according to the condition of the disease.

关 键 词：硬脊膜动静脉瘘 脊髓病 治疗 

分 类 号：R744.1[医药卫生—神经病学与精神病学]