早期显微手术治疗低级别Spetzler-Martin分级破裂出血性脑动静脉畸形的效果  

Early microsurgical treatment for hemorrhagic Spetzler-Martin low-grade cerebral arteriovenous malformation rupture:preliminary clinical experience

作　　者：方凯[1] 梁亚明[1] 陈文焰 卢伟坤 FANG Kai;LIANG Ya-ming;CHEN Wen-yan;LU Wei-kun(Department qf Neurosurgery,the Second People fs Hospital of Zhaoqing,Zhaoqing 526060,Guangdong,China)

机构地区：[1]肇庆市第二人民医院神经外科,广东肇庆526060

出　　处：《广东医学》2020年第21期2214-2218,共5页Guangdong Medical Journal

摘　　要：目的探讨Spetzler-Martin分级(SMG)为Ⅰ~Ⅱ和部分Ⅲ级脑动静脉畸形(AVMs)出血后72 h内显微手术治疗的临床效果.方法回顾性分析15例破裂出血的SMG为Ⅰ~Ⅱ和部分Ⅲ级脑AVMs患者的临床资料,所有患者均在发病后72 h内进行显微手术治疗.结果术后随访6~24个月,平均(7.9±4.5)个月,按GOS评分标准进行预后评定.其中GOS评分5分12例,4分3例.术后复查DSA显示14例患者畸形血管团全部切除,1例有少部分残留.结论在做好充分的术前影像检查和评估的前提下,早期显微手术治疗破裂出血的SMG为Ⅰ~Ⅱ和部分Ⅲ级脑AVMs是安全有效的.Objective To investigate the effect of microsurgical treatment in the first 72 hours after hemorrhage of Spetzler-Martin Grade(SMG) Ⅰ-Ⅱ and partial Grade Ⅲ cerebral arterio-venous malformations(AVMs). Methods The clinical data of 15 patients with rupture of SMG Ⅰ-Ⅱ and partial Ⅲ cerebral AVMs were retrospectively analyzed. All patients were treated with microsurgery in the first 72 hours after hemorrhage. Results The patients were followed-up after surgery for 6-24 months, the mean follow-up periods was(7.9±4.5) months. The outcomes were assessed with GOS score. Twelve patients recovered well with GOS score of 5. Three patients left moderate disability with GOS score of 4. DSA re-examination in fourteen patients showed that the malformed vascular mass was completely removed, and 1 patient had some small residual. Conclusion Early microsurgery for the SMG Ⅰ-Ⅱ and partial Ⅲ hemorrhagic AVMs is safe and effective under the condition of adequate preoperative imaging examination and evaluation. The prognosis is similar to that reported in the literature treated with staged surgery.

关 键 词：脑动静脉畸形 Spetzler-Martin分级 显微外科 早期手术治疗 

分 类 号：R651.12[医药卫生—外科学] R743.4[医药卫生—临床医学]