脑动静脉畸形破裂出血患者显微手术治疗评价

Evaluation of microsurgery in the treatment of cerebral arteriovenous malformation with rupture hemorrhage patients

目的 分析研究显微手术治疗脑动静脉畸形破裂出血患者的临床效果。方法 68例脑动静脉畸形并出血患者为研究对象,结合文献对患者的临床资料进行分析。结果 所有患者均进行了畸形血管团显微切除手术,其中60例为全切除,8例为次全切除,无手术死亡。术后严重脑梗死死亡3例,再出血自动出院死亡1例。其余64例门诊随诊6~12个月,根据格拉斯哥预后评分（GOS）良好31例,轻度残疾18例,中度残疾10例,严重残疾3例,植物状态2例。结论 采用显微手术切除畸形血管团是根治脑动静脉畸形、预防出血的可靠方法 ,其可以明显降低致死、致残率,提高治愈率,具有较好的临床应用价值。

Objective To analyze and research clinical effect of microsurgery in the treatment of cerebral arteriovenous malformation with rupture hemorrhage patients. Methods There were 68 cerebral arteriovenous malformation with rupture hemorrhage patients as study subjects, and their clinical data were analyzed in accordance with literature. Results All patients received microsurgica/resection of formation vascular mass. There were 60 complete resection cases and 8 partial resection cases, withont any death case in operation. There were 3 death eases due to severe postoperative cerebral infarction and 1 against advice discharge death case with rehaemorrhagia. Outpatient follow-up lasted for 6-12 months in the other 64 cases. Glasgow outcome scale （COS） showed 31 good cases, 18 mildly disabled cases, 10 moderately disabled cases, 3 severely disabled cases, and 2 cases in vegetative state. Conclusion Implement of mierosurgery for resection of formation vascular mass is creditable method for treating cerebral arteriovenous malformation and preventing rupture hemorrhage. This method can remarkably reduce moirtality and disability rate, and improve cure rate. It contains good value for clinical application.