摘要
目的探讨深部脑动静脉畸形(AVM)导致原发性脑室出血(PIVH)并急性梗阻性脑积水的早期治疗。方法对2001年6月～2004年6月收治的6例深部AVM导致PIVH并急性梗阻性脑积水患者,采用早期血管内栓塞治疗的AVM;侧脑室外引流结合管内应用尿激酶等方法进行治疗。以术后1个月和6个月的日常生活能力(ADL)评级作为疗效判断指标并随访10～46月(平均29.2m)。主要研究其临床特点和治疗策略。结果术后6个月ADL评级,5例达到Ⅰ～Ⅱ级,1例Ⅳ级;6例脑深部AVM均达到70%以上填塞;随访10～46月无再出血,效果令人满意。结论早期血管内栓塞治疗AVM、脑室外引流及管内应用尿激酶是治疗深部AVM导致PIVH并急性梗阻性脑积水安全有效的方法,早期血管内栓塞AVM可能有助于防止早期和远期再出血的发生。
Objective To explore the early treatment of deep-site arteriovenous malformation (AVM) which leading to primary intraventicular hemorrhage (PIVH) and acute non-communicated hydrocephalus. Methods By the method of endovascular embolization and ventricular drainage with urokinase,6 casaes of deep-site AVM that combined with PIVH and acute non-communicated hydrocephalus were early treated from Jun,2001,to Jun,2004.The patients were followed-up for 10～46 months (mean 29.2m). Results Activities of Daily Living (ADL) after 6 months was performed to find that 5 cases were in ADL Ⅰ-Ⅱ,1 case ADL-Ⅳ.All the cases achieved 70% embolism,no rebleeding occurred. Conclusion For deep-site AVM that combined with PIVH and acute non-communicated hydrocephalus,endovascular embolization and ventricular drainage with urokinase in early stage were safty and efficiency therapeutic strategy,early endovascular embolization may be helpful to prevent the occurrence of rebleed.
出处
《广州医药》
2005年第4期4-7,共4页
Guangzhou Medical Journal
