复合手术在治疗颅颈交接区硬脊膜动静脉瘘中的应用(附2例病例报道)

Hybrid operation for treatment of craniocervical junction-dural arterio venous fistulas(report of 2 cases)

目的探讨复合手术在颅颈交界区硬脊膜动静脉瘘(CCJ-DAVF)手术中的应用价值。方法回顾性分析2例在复合手术室手术治疗的CCJ-DAVF患者临床资料,并进行文献回顾。用改良Rankin评分(mRS)评价治疗效果,术后随访1~6个月。结果2例均以蛛网膜下腔出血(SAH)起病,术中均准确地找到瘘口并将其切断,即刻血管造影显示瘘口均完全消失。术中血管造影和图像融合时间分别为35 min,25 min,所有患者均未发生造影相关并发症,mRS评分分别为0分,1分。结论复合手术便于判断瘘口位置,确保瘘口全部闭塞,是一项安全、有效的技术。

Objective To evaluate the clinical values of hybrid operation for the treatment of craniocervical junction-dural arterio venous fistulas(CCJ-DAVF).Methods The clinical data of 2 CCJ-DAVF patients who received operation in the hybrid operating room were analyzed retrospectively,and the relevant literature were reviewed.The clinical efficacy was evaluated with the modified Rankin scale(mRS).The follow-up time was 1-6 months.Results Subarachnoid hemorrhage(SAH)occurred in both cases.The fistulas were all accurately found and obliterated.Intraoperative digital subtraction angiography(DSA)was performed immediately after obliterating,and confirmed that the fistulas were completely disappeared.The time cost of intraoperative DSA and image fusion was respectively 35minutes and 25 minutes.No DSA-related complications occurred.mRS scores were respectively 0 and 1.Conclusion Hybrid operation can help to judge the location of fistula and confirm obliteration of all the fistulas,which is a safe and effective technique.