|本期目录/Table of Contents|

[1]张建忠,李明,刘信龙,等.血管内栓塞联合手术切除Spetzler-Martin Ⅲ级出血性脑动静脉畸形[J].医学研究与战创伤救治(原医学研究生学报),2015,17(05):471-473.[doi:10.3969/j.issn.1672-271X.2015.05.007]
　ZHANG Jian-zhong,LI Ming,LIU Xin-long,et al.Endovascular embolization combined microsurgical treatment of Spetzler-Martin Ⅲ hemorrhagic cerebral arteriovenous malformations[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(05):471-473.[doi:10.3969/j.issn.1672-271X.2015.05.007]
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血管内栓塞联合手术切除Spetzler-Martin Ⅲ级出血性脑动静脉畸形()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年05期
页码:
471-473
栏目:
出版日期:
2015-09-30

文章信息/Info

Title:
Endovascular embolization combined microsurgical treatment of Spetzler-Martin Ⅲ hemorrhagic cerebral arteriovenous malformations
作者:
张建忠; 李明; 刘信龙; 徐正平; 杨冰; 许峰峰; 丁强; 李政卫
200052 上海，解放军455医院神经外科
Author(s):
ZHANG Jian-zhong;  LI Ming;  LIU Xin-long;  XU Zheng-ping;  YANG Bing;  XU Feng-feng;  DING Qiang;  LI Zheng-wei.
Department of Neurosurgery， 455 Hospital of PLA， Shanghai 200052， China
关键词:
血管内栓塞; 显微外科手术; 脑动静脉畸形; Spetzler-Martin Ⅲ
Keywords:
endovascular embolization;  microsurgery;  arteriovenous malformations;  Spetzler-Martin Ⅲ
分类号:
R743.4；R651.1
DOI:
10.3969/j.issn.1672-271X.2015.05.007
文献标志码:
A
摘要:
目的 探讨血管内栓塞联合手术切除治疗Spetzler-Martin Ⅲ级脑动静脉畸形(arteriovenous malformations，AVM)不同亚型的安全性及有效性。方法 回顾性分析29例Spetzler-Martin Ⅲ级AVM患者的临床资料，分为4个亚型，分别如下：T1=S1E1V1，T2=S2E1V0，T3=S2E0V1，T4=S3E0V0（S＝大小，E＝功能区，V＝深静脉引流）。全部患者行血管内栓塞，于术后7～14 d行显微外科手术，病灶完全切除。结果 显微外科手术完全切除畸形血管团，总体手术相关并发症率13.8%，T1型和T2型并发症率高于T3、T4型，其中血管栓塞相关并发症1例，无手术死亡，手术相关并发症3例。术后平均随访16个月，影像学检查未见AVM复发及再出血。结论 血管内栓塞加显微外科手术切除是治疗Spetzler-Martin Ⅲ级出血性AVM安全有效的方法，AVM位于功能区的T1、T2型手术风险较高。
Abstract:
Objective To investigate the safety and effectiveness of endovascular embolization combined microsurgical resection in treating Spetzler-Martin Ⅲ grade cerebral arteriovenous malformations（AVM） between different subtypes. Methods A retrospective analysis was used in 29 cases of patients with Spetzler-Martin Ⅲ AVM. They were divided into four subtypes， S=size， E=functional area， V=deep venous drainage， then T1=S1E1V1， T2=S2E1V0， T3=S2E0V1 ， T4=S3E0V0. All patients underwent microsurgical complete resection after 1 to 2 weeks with endovascular embolization. Results Nidus was completely removed after microsurgery resection. Overall procedure-related complication rate was 13.8%， of complications rate in T1 and T2 types was higher than T3， T4 types and endovascular embolization related complications was 1 case， surgery-related complications was 3 cases and there was no death. After follow-up with16 months， radiographic examination showed no AVM recurrence and rehemorrhage. Conclusion Endovascular embolization combined microsurgical resection in Spetzler-Martin Ⅲ hemorrhagic AVM is safe and effective， but T1 and T2 type have higher surgical risk due to locate eloquent cortex.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2015-09-20