硬脊膜动静脉瘘的治疗分析

目的 探讨硬脊膜动静脉瘘的治疗方法及其效果。方法 回顾性分析2015年3月到2018年3月收治的13例硬脊膜动静脉瘘的临床资料。采用显微手术治疗11例，采用血管内治疗2例。结果 术后均恢复良好，未发生并发症，均无新增神经功能缺失表现。术后随访6个月，未见硬脊膜动静脉瘘复发，脊髓功能障碍得到不同程度的改善。结论 硬脊膜动静脉瘘应尽早手术，目标是闭塞瘘口和静脉起始部；根据其血管构筑特点及瘘口部位，选择相应的治疗方法。血管内栓塞和显微手术均是安全、有效的治疗方式。

Clinical analysis of the diagnosis and treatment of spinal dural arteriovenous fistulae

Objective To investigate the treatment methods and outcomes of spinal dural arteriovenous fistulae (SDAVF). Methods The clinical data of 13 patients with SDAVF, of whom 11 received microsurgery and 2 endovascular embolization from March, 2015 to March, 2018, were analyzed retrospectively. Results All the patients were successfully treated by microsurgery or endovascular embolization. All the patients were recovered well without postoperative complications or neurologic defect. The following-up about 6 months after discharge from hospital showed that SDAVF did not recur in all the patients, in whom the spinal function improved differently in degree. Conclusions SDAVF should be operated as early as possible. The goal of microsurgery or endovascular embolization is the disconnection of the postfistula intradural shunting vein from the perimedullary venous plexus. The treatment method should be selected according to the angioarchitecture features and locations of the SDAVF. Microsurgery and endovascular emblization are the safe and effective methods to treat SDAVF.