复合手术室在硬脊膜动静脉瘘手术治疗中的应用

Appfication of hybrid operating room in the treatment of spinal dural arteriovenous fistulas

目的探讨应用复合（Hybrid）手术室治疗硬脊膜动静脉瘘（SDAVF）的经验。方法回顾性分析2011年3月至2016年2月天津医科大学总医院神经外科收治并应用Hybrid手术室＂一站式＂手术治疗SDAVF患者22例，采用改良Aminoff-Logue评分（ALS）评价脊髓功能。术后随访6个月至1年。结果患者均经全脊髓数字减影血管造影（DSA）确诊。术前轻度功能障碍15例，中度功能障碍6例，重度功能障碍1例，改良ALS为（4.7±1.8）分，术后6个月时随访治愈16例，改善5例，无变化1例，好转率95.45%，改良ALS为（2.0±1.5）分，术前和术后改良ALS比较差异有统计学意义（P〈0.01）。结论Hybrid手术室在SDAVF手术治疗中取得了良好的效果，体现了精准医疗的理念，为其治疗提供了一个便捷有效的新平台。

ObjectiveTo explore the experience in the treatment of spinal dural arteriovenous fistulas with application of hybrid operating room. MethodA retrospective analysis was performed among 22 patients with spinal dural arteriovenous fistulas admitted to Department of Neurosurgery of Tianjin Medical University General Hospital who received operation in the hybrid operating room from March 2011 to February 2016. Modified Aminoff-Logue scores （ALS） for myelopathy was used to evaluate the spinal function.All the 22 patients were followed up 6-12 months after the operation. ResultAll the patients were diagnosed by spinal digital subtraction angiography （DSA）. The modified ALS pre-operation and post-operation 6 months were （4.7±1.8） and （2.0±1.5）, respectively, with significant difference （P〈0.01）. There were 15 cases with mild dysfunction, 6 cases with moderate dysfunction, severe dysfunction in 1 case before operation.Fifteen cases were cured, 4 cases improved, 1 case had no change after 6 months follow-up.The improvement rate was 95.45%. ConclusionThe application of hybrid operating room in the treatment of spinal dural arteriovenous fistulas achieves good outcome and provides a convenient and effective approach, which embodies the idea of precision medicine.