高级别颅内动静脉畸形的治疗策略及并发症防治 |
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引用本文: | 刘方军,张永力,孙玉明,林达,周忠清,钱海,石祥恩. 高级别颅内动静脉畸形的治疗策略及并发症防治[J]. 中国微侵袭神经外科杂志, 2013, 0(10): 436-438 |
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作者姓名: | 刘方军 张永力 孙玉明 林达 周忠清 钱海 石祥恩 |
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作者单位: | 北京三博脑科医院首都医科大学第十一临床医学院神经外科,100093 |
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基金项目: | 国家临床重点专科建设项目(编号:SG2011-04-02) |
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摘 要: | 目的探讨高级别颅内动静脉畸形(arteriovenous malforation,AVM)的治疗策略及并发症防治。方法回顾性分析13例高级别AVM病人的临床资料,采用显微手术为主结合介入和(或)放射治疗。术中均应用自体血回吸收技术,2例术前行AVM部分栓塞.1例行分次手术,2例术后病变残留病人行伽马刀治疗。结果无死亡病例;1例术前持续昏迷,术后轻度改善;其余病例均得到较好恢复。AVM全切除11例,次全切除2例。随访11—59个月,GOS评分:5分10例,4分2例,3分1例。结论娴熟的显微神经外科技术、科学的个体化治疗方案的制定是取得高级别AVM良好疗效的重要因素。术前辅助行栓塞技术,术中应用自体血回收技术,术后放射治疗,可以降低并发症的发生。
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关 键 词: | 颅内动静脉畸形 显微外科手术 并发症 栓塞,治疗性 |
Treatment strategies and prevention of complication for high-grade intracranial arteriovenous malformation |
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Affiliation: | Liu Fangjun, Zhang Yongli, Sun Yuming, Lin Da, Zhou Zhongqing, Qian Hai, Shi Xiang'en. Department ofNeurosurgery, Beijing Sanbo Brain Hospital, 11th Clinical School, Capital Medical University, Beijing, 100093, China |
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Abstract: | Objective To investigate the treatment strategy and prevention of complications in patients with high-grade intracranial arteriovenous malformation (AVM). Methods The clinical data of 13 patients with high-grade intracranial AVM treated by microsurgery combined with embolization and/or radiosurgery were analyzed retrospectively. Intraoperative autologous blood transfusion was performed in all the patients. Preoperative embolization was done in 2 cases. Two-step procedure was conducted in 1 case. Gamma knife was used in 2 patients who were found having residual nidus after the operation. Results No death occurred. One patient with persistent coma before the operation recovered a little. And the other patients recovered well. The total remove of AVM was achieved in 11 patients and subtotal remove in 2. During a follow-up period of 11-59 months, Glasgow Outcome Scale (GOS) was 5 in 10 cases, 4 in 2 and 3 in 1 case. Conclusions To obtain good effects in treatment of high-grade intracranial AVM, skilled neurosurgery technique and well individualized plan are very important. Skilled neurosurgical technique and scientific personalized medicine are important factors for good therapeutic efficacy of high-grade intracranial AVM. Preoperative embolization, intraoperative autologous blood transfusion, postoperative radiotherapy can reduce the incidence of complication. |
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Keywords: | intracranial arteriovenous malformations microsurgery complications embolization, therapeutic |
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