小脑动静脉畸形的显微手术治疗

Microsurgical treatment of cerebellar arteriovenous malformation

目的 评价显微手术治疗小脑动静脉畸形（AVM）的临床应用价值.方法 收集2009年1月-2014年10月在中山大学附属第一医院进行显微手术治疗的17例小脑AVM,记录病例的临床特征、治疗经过和相关并发症,出院前复查MRI和DSA,出院和随访采用改良Rankin评分（mRS）评价.结果 17例手术均全切除AVM,发生治疗相关并发症3例：其中后组脑神经功能损伤1例、共济失调l例、术后出血l例;其余14例（14/17）患者治疗后情况比入院时改善或持平.出院的mRS评分,小于3分15例（15/17）;随访0.5-5.0年的mRS评分,均小于3分.结论 显微手术切除小脑AVM可以取得理想的临床疗效.

Objective To evaluate the clinical application of microsurgical treatment of cerebellar arteriovenous malformation （AVM）.Methods From January,2009 to October,2014,there were 17 patients with cerebellar AVM treated by microsurgery in the First Affiliated Hospital of Sun Yat-sen University.The clinical features,therapeutic process,complications and discharge status were recorded in details.The prognosis was estimated by modified Rankin scale （mRS） with 0.5-5.0 years＇ followed-up.Results All of the AVMs were totally resected.The therapy-related complications happened in 3 patients （3/17）.Among them,1 patient had dysfunction of central nervous system （1/17）,1 patient suffered from ataxia and 1 case with intra-cerebral hemorrhage.The result of mRS 〈 3 was seen in 15 cases （15/17） when discharged from hospital.Good recovery of mRS 〈 3 was seen in all 17 cases with 0.5-5.0 years＇ followed-up.Conclusion Microsurgical treatment of cerebellar AVM should be a good therapeutic strategy.