分次血管内介入栓塞治疗功能区大型脑动静脉畸形  

Technique of fractionated intravascular interventional embolization for large cerebral arteriovenous malformation in eloquent area

作　　者：马骏[1] 路华[2] 刘宁[2] 耿晓增[2] 李征[2] 朱海峰[3] MA Jun;LU Hua;LIU Ning(Department of Neurosurgery,The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学第二附属医院神经外科,南京210011 [2]南京医科大学第一附属医院神经外科 [3]盐城市阜宁县人民医院

出　　处：《临床神经外科杂志》2018年第6期419-423,共5页Journal of Clinical Neurosurgery

基　　金：2017年度江苏省中医药科技项目(YB2017093);南京医科大学科技发展基金重点项目(2016NJMUZD026)

摘　　要：目的探讨分次血管内介入栓塞技术治疗功能区大型脑动静脉畸形的疗效和策略。方法南京医科大学第一附属医院神经外科2015年1月至2017年12月对34例功能区大型脑动静脉畸形患者行分次血管内栓塞治疗。动静脉畸形位于额顶叶16例,额颞顶9例,颞顶叶9例。动静脉畸形患者首次栓塞60%后,平均间隔2～3个月再次行栓塞,残留<20%的患者予以伽玛刀放射治疗,<10%者予以随访观察。结果经过2～3次的栓塞治疗,34例患者中完全栓塞者16例,残余10%以下者6例,残余10%～20%者12例。随访半年,本组患者均无严重功能障碍,无死亡病例。结论分次血管内栓塞技术治疗功能区脑动静脉畸形的效果好,值得在临床推广应用。Objective To explore the therapeutic effect and strategy of fractionated intravascular interventional embolization for cerebral arteriovenous malformation(AVM)in the eloquent area.Methods 34 patients with AVM in functional regions treated with intravascular embolization were enrolled in this study from January 2015 to December 2017.The large brain AVMS were mainly located in frontal parietal lobe(16 cases),frontal and temporal parietal lobe(9 cases)and temporal parietal lobe(9 cases).The first time intravascular embolization of AVM resulted in 60%occlusion of the malformed vessels.Then after an average interval of 2-3 months make the re-embolization.Patients with less than 20%residues were treated by gamma knife radiotherapy,while patients with less than 10%residues only need follow-up.Results 34 patients had two to three surgeries,16 cases were completely embolized,12 cases were remained 10%-20%,and 6 cases were remained 10%.During the six months follow-up,none of the patients have serious complications and none of the patients die.Conclusion The fractionated embolization technique for AVM in functional area is good,and it is worthy of clinical application.

关 键 词：分次栓塞 动静脉畸形 功能区 

分 类 号：R743.4[医药卫生—神经病学与精神病学]