脊髓髓周动静脉瘘的诊治分析:附3例报道并文献复习

Diagnosis and treatment of spinal perimedullary arteriovenous fistulas:report of 3 cases and review of literature

目的总结脊髓髓周动静脉瘘(SPAVF)的诊断和治疗经验。方法回顾性分析我院收治的3例SPAVF的临床资料,对其诊断、治疗方案及结果进行分析。结果3例均行选择性脊髓动脉造影确诊,1例行显微手术灼闭瘘口,2例行血管内栓塞治疗,均成功闭塞瘘口,术后病人下肢肌力恢复至5级,感觉及大小便功能正常。结论选择性脊髓动脉造影是诊断SPAVF的金标准,手术灼闭或栓塞瘘口均是治疗SPAVF的有效方法,介入栓塞治疗创伤小,可首选。

Objective To summarize the experience in diagnosis and treatment for the patients with spinal perimedullary arteriovenous fistula(SPAVF).Methods The clinical data of 3 patients with SPAVF were analyzed retrospectively.The diagnosis,treatment and outcomes were analyzed.Results All the 3 patients received the selective spinal arteriography to confirm the diagnosis.One patient underwent microsurgery to cauterize the fistula,and 2 underwent intravascular embolization.The fistulas were successfully occluded in all the patients.After the operation,the muscle strength of the lower limbs returned to grade 5 and the sensory and urine functions were normal in all the patients.Conclusions Selective spinal arteriography is the gold standard for the diagnosis of SPAVF.Surgical cauterization or embolization of fistulas are both good methods for the treatment of patients with SPAVF.Interventional embolization is the first choice because of its mild surgical injury.