复合手术在复杂脑血管疾病中的初步应用  

Preliminary application of hybrid operation in complex cerebrovascular diseases

作　　者：王坤 秦琨[2] 陈光忠[2] 彭超[2] 邓先明[1,2] 周东 林晓风[2] Wang Kun;Qin Kun;Chen Guangzhong;Peng Chao;Deng Xianming;Zhou Dong;Lin Xiaofeng(The Second School of Clinical Medicine,Southern Medical University,Guangzhou,Guangdong 510280,China;Department of Neurosurgery,Guangdong Provincial People's Hospital,Guangzhou,Guangdong 510080,China)

机构地区：[1]南方医科大学第二临床医学院,广州510280 [2]广东省人民医院神经外科,广州510080

出　　处：《中国微侵袭神经外科杂志》2020年第11期500-503,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨复合手术在复杂性脑血管疾病中的临床应用效果。方法回顾性分析10例行复合手术治疗的脑血管病病人的临床资料及疗效。结果5例颅内动静脉畸形(arteriovenous malformation,AVM)术后即时造影见畸形团完全切除;3例慢性颈内动脉闭塞中,血流恢复2例,未恢复1例;2例动脉瘤病人(共3枚动脉瘤)根据即时造影调整动脉瘤夹后载瘤动脉通畅,动脉瘤夹闭完全。10例术后随访3~12个月,均无手术相关并发症。5例颅内AVM病人术后症状均改善,无残留及复发;3例颈内动脉再通病人中,2例术后头晕缓解、肢体乏力改善,1例经康复治疗部分改善。3枚动脉瘤术后无瘤颈残留及复发。结论复合手术在颅内AVM一期治愈性切除、慢性颈动脉闭塞再通及疑难动脉瘤夹闭等复杂脑血管病治疗中具有良好的应用效果,可实现外科手术与介入治疗的优势互补。Objective To investigate the clinical application value of hybrid operation in complex cerebrovascular diseases.Methods Clinical data and therapeutic effect of 10 patients with cerebrovascular disease undergoing hybrid operation were analyzed retrospectively.Results Immediate postoperative DSA revealed that the malformed vessels were totally removed in 5 patients with intracranial arteriovenous malformations(AVM).In 3 patients with chronic internal carotid artery occlusion,2 restored blood flow but 1 failed.Three aneurysms were clipped completely,and the parent artery was unobstructed after adjusting the aneurysm clips depending on the immediate angiography in 2 patients.Ten patients were followed up for 3 to 12 months and no complications observed.The symptom of 5 AVM patients achieved improvement after surgery,and the malformation had no residual or recurrence.In 3 patients with recanalization,2 had relief of dizziness and contralateral limb weakness,and 1 patient was partially improved after rehabilitation treatment.There was no residual or recurrence after the operation of 3 aneurysms.Conclusions Hybrid operation has a good application effect in complex cerebrovascular disease,can realize a complementary combination of traditional surgery and interventional operation,especially in hemorrhagic AVM achieving healing resection in the same stage,chronic internal carotid artery occlusion-recanalization and complex aneurysm clipping.

关 键 词：复合手术 颅内动静脉畸形 慢性颈内动脉闭塞 颅内动脉瘤 

分 类 号：R651.11[医药卫生—外科学]