脊髓动静脉畸形治疗方法及疗效研究

目的 评价血管内治疗和手术治疗脊髓动静脉畸形的短期和长期疗效。方法 对103例脊髓动静脉畸形的患者进行血管内治疗34例，占33．0％；手术治疗69例，占67．0％。治疗前、后行脊髓血管造影检查，评估治疗的影像学效果。使用阿米诺夫量表评估治疗前、后脊髓功能的改变，x^2检验用于分析两种治疗方法的短期和长期疗效。结果 两组患者中脊髓畸形血管团完全清除60例，占58．3％；部分清除43例，占41．7％。术后1个月的治疗效果为：治愈19例(18．4％)，改善14例（13．6％），无变化57例(55．3％），恶化13例（12．6％)；随访6个月的治疗效果为：治愈26例(25．2％)，改善33例(32．0％)，无变化29例（28．2％)，恶化15例(14．6％)。结论 脊髓畸形血管团完全清除的患者比部分清除的患者获得更好的长期治疗效果。手术治疗方法更有利于完全清除畸形血管团，血管内治疗畸形血管团的完全清除率虽然相对较低，但短期疗效却优于手术治疗。

The efficiency of different therapeutic methods for treatment of spinal cord intramedullary AVM

Objective To evaluate the efficiency of different therapeutic methods for the spinal intramedullary AVMs. Methods Total of 103 cases were reviewed, with more than 6 months follow-up results. 34 cases (33.0%) were only received embolization, surgery only and surgery after embolization were used in 69 cases (67%). Results According to the angiographic results, the patients were classified into complete obliterating group (60 cases, 58.3%) and partial obliterating group (43 cases, 41.7%). Using the functional scale of Aminoff & Logue, the result was divided into 4 groups: cured, improved, unchanged, and deteriorated. Follow up of 1 month postoperatively showed: 19 cases (18.4%) cured, 14 cases (13.6%) improved, 57 cases (55.3%) unchanged, 13 cases (12.6%) worsen. Follow up of 6 months postoperatively showed: 26 cases (25.2%) cured, 33 cases (32.0%) improved, 28 cases (28.2%) unchanged, 15 cases (14.6%) worsen. All the data was analyses by chi-square test. Conclusion The long term result of complete obliterating group is better than that of partial obliterating group. The complete obliterating rate in the surgery only and surgery after embolizating group is higher than that in the embolization group. But the effect of embolization group is better than that of surgical treatment in the short term postoperatively.