105例脑动静脉畸形并出血的外科治疗

The surgical treatment of cerebral arteriovenous malformation combinated hemorrhage(105 cases)

目的探讨脑动静脉畸形及合并出血后外科治疗方法的选择。方法105例病人根据脑动静脉畸形的分级、出血的部位、出血量的大小及病人的状况等选择手术、栓塞或栓塞后手术等方法治疗。结果手术组60例,全切除55例,占92%;部分切除5例,占8%。血管内治疗40例,一次全部栓塞的15例,占37%;分次全部栓塞的18例,占45%;部分栓塞的7例,占18%。血管内治疗后手术5例,全切除3例,占60%;部分切除2例,占40%。治愈91例,治愈率为86%;好转6例,占6%;死亡8例,占8%。结论手术治疗和血管内治疗是目前治疗脑动静脉畸形并出血的有效方法。

Objective To explore the methods and therapeutic effects of the cerebral arteriovenous malformation （ AVM ） combinated hemorrhage, Methods The clinical data of 105 patients treated by microsurgical operation or embolization or operation after embolization, based on classfication of AVM, the location and the size of hemorrhage and the status of patients. Results Total resection of AVMs was 55 cases（92% ） , partial resection 5 cases（8% ）. Total embolization of AVMs in first traeatment was attained in 15 cases（37% ） , total embolization of AVMs in several traeatment was 18 cases（45% ）, partial embolization in 7 cases（ 18% ）. Total resection of AVMs after embolization was 3 cases（60% ） , partial resection in 2 cases（40% ）. 91 cases were cured （86%） ; 6 cases were partial cured （6%） ; 8 cases were died （ 8% ）. Conclusion Microsurgical operation or embolization is an effective treatment of cerebral AVMs. Mierosurgical operation is the preferred choice to the cerebral AVMs combinated hemorrhage. It can resect AVM, clean out hemorrage, and release oppression of brain. Embolization is a safe and effective treatment. It can reduce the danger of operation of the huge cerebral AVM and improve the security.