脑动静脉畸形显微外科切除在基层医院的临床效果与安全性评价

Clinical evaluation of microsurgical resection for cerebral arteriovenous malformations in primary hospitals

目的探讨在基层医院对脑动静脉畸形(AVM)患者实施显微外科切除术的效果与安全性。方法选取我院2017年3月～2018年12月收治的行传统直视下AVM切除术患者50例为对照组,并选择同期行显微镜下AVM显微外科切除术患者45例为实验组,比较两组临床疗效。观察两组ADL评分、血清MMP-2与MMP-9水平、不良反应发生率,取患者入院第2天清晨空腹外周静脉血与手术治疗后第3天清晨空腹外周静脉血5 mL,采用酶联免疫吸附测定法进行测定。结果实验组总有效率(91.11%)优于对照组(68.00%),实验组术后复发率(6.67%)低于对照组(38.00%),差异有统计学意义(χ2=11.365,P=0.0007);术后实验组血清MMP-2与MMP-9水平低于对照组,且日常生活能力评分更高(P<0.05)。结论 AVM病情复杂多变,显微外科切除术可有效提高临床治疗效率,降低术后并发症发生率,改善患者生活质量,值得基层医院推广。

Objective To investigate the effect and safety of microsurgical resection in the treatment of cerebral arteriovenous malformations (AVM) in primary hospitals.Methods Fifty patients recieved AVM resection under conventional direct vision from March 2017 to December 2018 in our hospital were selected as the control group.Forty-five patients underwent microsurgical AVM microsurgery at the same time were choosed as the experimental group.The clinical efficacy between two groups was compared.Results The total effective rate of the experimental group (91.11%) was significantly higher than that of the control group (68.00%).The recurrence rate of the experimental group (6.67%) was significantly lower than that of the control group (38.00%)(χ^2=11.365,P=0.0007).The serum levels of MMP-2 and MMP-9 in the experimental group were lower than those in the control group,and the daily living ability score was significantly higher (P<0.05).Conclusion The condition of AVM is complex and changeable.The microsurgical resection can effectively improve the clinical treatment effect,reduce the incidence of postoperative complications and improve the life quality of the patients.It’s worth popularizing in the primary hospitals.