脑血管畸形急性出血外科治疗效果分析

Effect analysis of surgical treatment for acute hemorrhage of cerebral vascular malformations

目的分析与探讨脑血管畸形急性出血的外科治疗效果。方法本文回顾性分析了2004年6月～2011年6月本院收治的40例脑血管畸形急性出血患者的临床资料,其中行血肿清除加脑血管畸形切除术患者19例,行血肿清除加Ⅱ期脑血管畸形切除术患者9例,行脑室外引流加Ⅱ期脑血管畸形切除术患者7例,行血肿清除加去除骨瓣减压手术5例。结果 40例患者中治愈37例,死亡3例。治疗效果优24例,良9例,差4例。术后随访患者37例,随访时间为6个月～3年,22例患者恢复工作,10例患者生活能够自理,5例患者仍需要他人照顾。结论对于脑血管畸形急性出血的外科治疗,应根据患者的病情选择恰当的手术方式,清除血肿,妥善处理脑血管畸形团,以实现改善病症与解除病因的目的。行血肿清除加脑血管畸形切除术可以促使患者术后身体功能的恢复,有效降低致残率。

Objective To observe and investigate the effect of surgical treatment for acute hemorrhage of cerebral vascular malformations. Methods Forty cases of cerebral vascular malformation underwent surgical from June 2004 to June 2011 were retrospectively reviewed, including hematoma debridement plus cerebral vascular malformation excision in 19 cases, hematoma debridement plus stage II cerebral vascular malformation excision in 9 cases, extemal ventricular drainage plus stage II cerebral vascular malformation excision in 7 cases, and hematoma debridement plus skull windowing decompres- sion in 5 cases. Results Thirty-seven cases were cured and 3 deaths occurred. The therapeutic effect categorized as excel- lent in 24 cases, fair in 9 cases and poor in 4 cases. With 6 months to 3 years follow-up in 37 cases, 22 cases went back to work, 10 cases went back to self-care and 5 cases still needed assisting in life. Conclusion The both aims of eliminat- ing causes and reducing symptoms can be achieved by hematoma clearance and proper treating cerebral vascular malfor- mation nidus. Hematoma debridement and cerebral vascular malformation excision can promote the recovery of patients＂ physical function and reduce disabled rate.