中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2008年
7期
532-534
,共3页
沈剑峰%徐庆生%王明%严敏%叶科%马跃辉%郑杰胜%周永庆%詹仁雅%贺红卫%吴中学
瀋劍峰%徐慶生%王明%嚴敏%葉科%馬躍輝%鄭傑勝%週永慶%詹仁雅%賀紅衛%吳中學
침검봉%서경생%왕명%엄민%협과%마약휘%정걸성%주영경%첨인아%하홍위%오중학
颅内动静脉畸形%栓塞%Spetzler-Martin Ⅳ～Ⅴ级%Onyx
顱內動靜脈畸形%栓塞%Spetzler-Martin Ⅳ～Ⅴ級%Onyx
로내동정맥기형%전새%Spetzler-Martin Ⅳ～Ⅴ급%Onyx
Intracranial arteriovenous malformations%Embolism%Spetzler-Martin gradeⅣ～Ⅴ%Onyx
目的 探讨高级别(Spetzler-Martin Ⅳ～Ⅴ级)脑动静脉畸形(AVMs)治疗中Onyx液态栓塞剂的方法和作用.方法 回顾性分析32例高级别AVMs运用Onyx治疗的临床资料,并对高级别AVMs的手术适应证以及手术方法的选择加以讨论.结果 运用Onyx液态栓塞剂治疗26例高级别AVMs,经过血管内栓塞治疗后完全栓塞13例,大部栓塞10例,不全栓塞3例.其中10例经过手术和(或)放射治疗,随访期间,全脑血管造影检查提示动静脉闭塞23例;26例患者恢复良好,术后出血2例,未见新的神经功能损害出现,无死亡病例.结论 对于高级别AVMs,首选用Onyx液态栓塞剂治疗,采用微导管超选到位、控制性注射以及对静脉的保护,可以改善高级别AVMs的疗效.
目的 探討高級彆(Spetzler-Martin Ⅳ～Ⅴ級)腦動靜脈畸形(AVMs)治療中Onyx液態栓塞劑的方法和作用.方法 迴顧性分析32例高級彆AVMs運用Onyx治療的臨床資料,併對高級彆AVMs的手術適應證以及手術方法的選擇加以討論.結果 運用Onyx液態栓塞劑治療26例高級彆AVMs,經過血管內栓塞治療後完全栓塞13例,大部栓塞10例,不全栓塞3例.其中10例經過手術和(或)放射治療,隨訪期間,全腦血管造影檢查提示動靜脈閉塞23例;26例患者恢複良好,術後齣血2例,未見新的神經功能損害齣現,無死亡病例.結論 對于高級彆AVMs,首選用Onyx液態栓塞劑治療,採用微導管超選到位、控製性註射以及對靜脈的保護,可以改善高級彆AVMs的療效.
목적 탐토고급별(Spetzler-Martin Ⅳ～Ⅴ급)뇌동정맥기형(AVMs)치료중Onyx액태전새제적방법화작용.방법 회고성분석32례고급별AVMs운용Onyx치료적림상자료,병대고급별AVMs적수술괄응증이급수술방법적선택가이토론.결과 운용Onyx액태전새제치료26례고급별AVMs,경과혈관내전새치료후완전전새13례,대부전새10례,불전전새3례.기중10례경과수술화(혹)방사치료,수방기간,전뇌혈관조영검사제시동정맥폐새23례;26례환자회복량호,술후출혈2례,미견신적신경공능손해출현,무사망병례.결론 대우고급별AVMs,수선용Onyx액태전새제치료,채용미도관초선도위、공제성주사이급대정맥적보호,가이개선고급별AVMs적료효.
Objective To investigate the application of Onyx in the treatment of cerebral AVMs on Spetzler-Martin grade Ⅳ～Ⅴ. Method 32 cases of cerebral AVMs on Spetzler-Martin grade Ⅳ～Ⅴ were treated with Onyx, and ten of them were combined with microsurgical resection and stereotactic radiosurgery,then the indications and approaches of high grade AVMs were analyzed retrospectively. Results 26 cases were underwent intravascular embolization. Among them, 13 cases were totally occluded with Onyx, 10 cases were subtotally occluded and 3 cases were partially embolized. 10 patients were treated combining with micrnsurgical resection and stereotactic radiosurgery. Cerebral hemorrhage occurred in 2 cases and no new nerve system deficits appeared in follow-up, no case died. Conclusions Onyx is a safe and effective liquid embolic agent for use in the treatment of cerebral AVMs on Spetzler-Martin grade Ⅳ～Ⅴ. Superselective intranidal catheter positions and slow, controlled injections that protect the draining veins make the therapy safe in high grade of AVMs.
