小儿脑动静脉畸形破裂出血并脑疝急诊手术疗效分析

Analysis of the efficacy of emergent operation on children with rupture and hemorrhage of arteriovenous malformation of brain complicated with cerebral hernia

目的分析急诊手术治疗小儿脑动静脉畸形(AVM)破裂出血并脑疝的效果。方法回顾性分析80例AVM破裂出血并脑疝患儿的临床资料,急诊行血肿清除+去骨瓣减压术。结果 74例行血肿清除加AVM全切除术,6例未切除行介入治疗;术后死亡1例,死因为多器官功能衰竭;术后随访6个月,依照GOS评级,恢复良好59例,轻残14例,重残4例,植物生存2例。结论急诊手术治疗AVM破裂出血并脑疝可尽早清除血肿,解除占位效应与颅内高压,改善神经功能,能够有效降低病死率。

Objective To analyze the effect of emergent operation on children with rupture and hemorrhage of arteriove-nous malformation complicated with cerebral hernia .Methods The clinical data of 80 children with AVM rupture and hemor-rhage complicated with cerebral hernia were analyzed retrospectively .And all cases received emergent operation of decompres-sive craniectomy and hematoma clearance .Results Seventy-four children received hematoma clearance and AVM total resec-tion ,6 cases who couldn’t receive AVM resection received interventional treatment .1 case died after operation ,and the reason was function failure of organs .The patients were followed up for 6 months after operation .According to GOS grade ,59 cases recovered well ,14 cases were light disability ,4 cases were severe disability ,and 2 cases were persistent vegetative state .Con-clusion Emergent operation treating rupture and hemorrhage of arteriovenous malformation complicated with cerebral hernia not only can clear the hematoma early and relieve the location effect and intracranial hypertension ,but also can improve neuro-logic function and effectively reduce the mortality .