摘要
目的:对脑动静脉畸形各种治疗方法的优缺点进行分析探讨。方法:483例脑动静脉畸形患者分为显微手术治疗组、伽玛刀治疗组、血管内治疗组、保守治疗组,通过随访(平均随访时间2.5年),分析各治疗方法的疗效、风险及预后。结果:显微手术治疗组的全切除率为93.5%,近期并发症发生率为29.4%,远期永久性并发症的发生率为6.75%,再出血率为1.84%,总病死率为1.23%。伽玛刀治疗组无近期并发症,远期并发症率为3.6%,再出血率为12.5%,无死亡。血管内治疗组近期并发症发生率为19.9%,远期永久性并发症发生率为6.0%,再出血率为21%,总病死率为7.0%。保守治疗组再出血率为3.33%,无死亡。结论:显微手术治疗仍是治疗动静脉畸形最可靠的方法,伽玛刀和血管内治疗是多手段联合治疗中的重要组成部分。
Objective： To analyze different treatment methods for cerebral arteriovenous malformations （AVMs）. Methods： Of 483 patients with AVMs in Beijing Tiantan Hospital from 2000 to ：2003, 136 patients were treated with endovascular embolization, 204 patients operated, 77 patients treated with gamma knife surgery, and 64 patients treated conservatively. The patients were followed up for 1 to 5 years, The efficacy and prognosis of different methods were analyzed. Results： In the group of microsurgical resection, the incidence of complication was 29.4%, and the permanent complication was 6.75%; the mortality rate was 1.23%, and the total excision was performed in 93.5% of the cases; the incidence of posttreatment hemorrhage was 1.84%. In the group of gamma knife surgery, the permanent complication was 3.6%;the incidence of posttreatment hemorrhage was 12.5% and no case died. In the group of endwascular embolization, the incidence of complication was 19.9%, and the permanent complication was 6.0%; the incidence of posttreatment hemorrhage was 21.0%, and the mortality rate was 7.0%. The incidence of hemorrhage of conservatively treated patients was 3.33% and no patient died. Conclusion： Tile microsurgical resection is the most reliable treatment for AVM. In some AVM cases combination therapy is necessary.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2006年第12期1212-1216,共5页
Journal of Nanjing Medical University(Natural Sciences)
关键词
脑动静脉畸形
显微神经外科
血管内治疗
立体定向放射治疗
arteriovenous malformations
microneurosurgery
endovaseular therapy
stereotactic radiosurgery
