幕上脑动静脉畸形 CAVM 破裂出血的显微外科治疗 附85例分析

　　【摘要】 目的 通过总结脑动静脉畸形并出血显微外科治疗患者的临床资料和术后随访，探讨脑动静脉畸形(AVM)并出血的显微外科治疗的手术方法及效果，提高AVM的诊治水平。方法 回顾性分析85例脑动静脉畸形并出血病人的临床资料，并结合文献进行分析。 结果 本组病例存活85例，死亡0例。疗效：优49例，良29例，差7例。随访85例，随访时间为出院后1个月～2年，恢复工作68例，自理生活28例，需要他人照顾7例。结论 根据病情选择合适的显微外科手术方式能够改善预后，血肿清除加AVM切除是该病首选治疗方法。

　　【关键词】 脑动静脉畸形; 颅内出血;显微外科治疗

　　Analysis on microsurgical treatment of arteriovenous malformations and intracranial hemorrhage(report of 85 cases)

　　ZHAO Xiao-yong,XIAO Hua,WANG Guo-xing,et al. Department of Neurosurgery,Huadu Hospital,Southern Medical University，Guangzhou 510800,China

　　[Abstract] Objective We summarized the clinical data and follow-up of arteriovenous malformations (AVM) and intracranial hemorrhage patients treated by microsurgical treatment，to explore the microsurgical methods and effects of AVM and intracranial hemorrhage，to raise the diagnosis and treatment of AVM.Methods Retrospective analysis were employed to analyze the clinical data about 85 cases of AVM and intracranial hemorrhage，combined with analysis of the literature.Results In this group，85 cases survived，without death. Superior effect were in 49 cases，general effect in 29 cases，poor effect in 7 cases. We have followed-up 85 cases for one months to two years after discharge from hospital. 68 cases was back to work，28 cases can live by themselves，7 cases needs to take care of by others.Conclusions According to the patients’ condition to choose a suitable microsurgical method can improve the prognosis，hematoma cleaning and AVM resection is the preferred treatment for the disease.

　　[Key words] arteriovenous malformations; intracranial hemorrhage; microsurgical treatment

　　脑动静脉畸形(arteriovenous malformation，AVM)是指脑血管发育障碍引起的脑局部血管数量和结构异常，并对正常脑血流产生影响[1]。我院自2007年3月-2010年1月对脑AVM并出血的患者进行开颅显微手术治疗85例,现报告如下。

　　1 资料与方法

　　1.1 一般资料 本组85例，男51例，女34例;年龄21～66岁，平均47.5岁。58例无明显诱因，剧烈活动、情绪激动下诱发20例，7例有高血压病史。病程1～5天，平均3天。

　　1.2 临床表现 (1)均为急性起病，主要表现为突发头痛70例(头痛加剧伴呕吐28例)，癫痫15例(均为首次发作)。(2

[1] [2] [3] [4] 下一页