CAJ | 학술논문

目的探讨B超、神经导航以及吲哚菁绿血管造影在颅内动静脉畸形手术中的应用价值.方法回顾性分析2009年1至10月北京天坛医院神经外科脑血管病区收治的43例颅内动静脉畸形患者临床资料.其中男26例,女17例;年龄8～53岁,平均26.51岁.所有患者在手术中分别或联合采用B超、神经导航或吲哚菁绿血管造影辅助病灶切除,且术后全部病例行脑血管造影(DSA)或CTA检查,同时记录术后新发并发症及恢复情况.结果所有患者均全切病灶,术中辅助技术检测结果均与术后DSA或CTA吻合.术后新发神经功能障碍3例(7.0%),其中2例出现双侧视野同向性偏盲,另1例为复视.43例患者KPS(Karnofsky Performance Scale)评分均高于80分.结论采用B超、神经导航或吲哚菁绿血管造影技术辅助颅内动静脉畸形手术切除,均有助于鉴别血管性质和反映病灶边界.但其侧重各有不同.因此,该3种辅助技术有选择的联合应用可以使术者增加术中判断的准确性,从而收到最佳手术效果.
목적 탐토B초、신경도항이급신타정록혈관조영재로내동정맥기형수술중적응용개치.방법 회고성분석2009년1지10월북경천단의원신경외과뇌혈관병구수치적43례로내동정맥기형환자림상자료.기중남26례,녀17례;년령8～53세,평균26.51세.소유환자재수술중분별혹연합채용B초、신경도항혹신타정록혈관조영보조병조절제,차술후전부병례행뇌혈관조영(DSA)혹CTA검사,동시기록술후신발병발증급회복정황.결과 소유환자균전절병조,술중보조기술검측결과균여술후DSA혹CTA문합.술후신발신경공능장애3례(7.0%),기중2례출현쌍측시야동향성편맹,령1례위복시.43례환자KPS(Karnofsky Performance Scale)평분균고우80분.결론 채용B초、신경도항혹신타정록혈관조영기술보조로내동정맥기형수술절제,균유조우감별혈관성질화반영병조변계.단기측중각유불동.인차,해3충보조기술유선택적연합응용가이사술자증가술중판단적준학성,종이수도최가수술효과.
Objective To evaluate the surgical effects of such adjuvant techniques as type B ultrasound, neuronavigation and intraoperative indocyanine green vedioangiography (ICGA) on intracranial arteriovenous malformation ( AVM) surgery. Methods From January to October 2009, 43 AVM patients treated at our center were retrospectively studied, including 26 males and 17 females with an age range of 8 to S3 years old (mean; 26. 51). Type B ultrasound, neuronavigation or ICCA were employed during surgical procedures in all cases. Intraoperative findings were compared with those of postoperative digital subtraction angiography ( DSA) or computed tomography angiography (CTA) . And the clinical outcomes were evaluated. Results As confirmed by postoperative DSA or CTA, the lesions of all 43 patients were totally removed. Only 3 patients (7.0%) suffered from new neurological deficits, including homonymous hemianopia in 2 patients and diplopia in 1. And the Karnofsky performance scale was higher than 80 for each patient. Conclusion The feeding arteries and draining veins can be differentiated by intraoperative type B ultrasound, neuronavigation and ICGA. All three adjuvant techniques can define the lesion boundary. However, each of them has its own benefits and drawbacks. It indicates that the combination of two or more techniques may help to improve the quality and outcome of surgical procedures.