脑动静脉畸形并出血的手术治疗

Surgical Treatment for Hemorrhage from Intracranial Arteriovenous Malformation

目的 探讨脑动静脉畸形（AVM）并出血的手术方法及治疗效果。方法 回顾性分析37例脑动静脉畸形并出血病人的临床资料，行血肿清除加AVM切除20例，血肿清除加Ⅱ期AVMe切除8例．脑室外引流加Ⅱ期AVM切除5例，血肿清除加去骨瓣减压术4例。结果 本组病例存活34例，死亡3例。疗效优23例，良8例，差3例。随访34例，时间6～36月，恢复工作2l例，自理生活9例，需要他人照顾4例。结论 根据病情选择合适的手术方式能改善预后，血肿清除＋AVM切除是该病首选治疗方法。

Objective To investigate the surgical treatment for hemorrhage from intracranial arteriovenous malformation（ AVM ）. Methods 37 cases of intracranial AVM underwent surgical treatment were retrospectively reviewed, including hematoma debridement plus AVM excision in 20 cases, hematoma debridement plus secondary AVM excision in 8 cases, external ventricular drainage plus stage Ⅱ AVM excision in 5 cases, and hematoma debridement plus skull windowing decompression in 4 cases. Result 3 deaths occurred. The therapeutic effect categorized as excellent in 23 cases, fair in 8 cases and poor in 3 cases. With 6 to 36 months follow-up in 34 cases, 21 cases back to work, 9 cases back to self-care and 4 cases need assisting in life. Conclusion Hematoma debridement and AVM excision is the optimal treatment.