CAJ | 학술논문

目的：总结颅内动静脉畸形急性出血的治疗方法。方法分析近4 a我院收治的22例颅内动静脉畸形急性出血病人，16例因出血量大，急诊开颅手术清除血肿并切除畸形血管团，6例出血量较小的病人，先行头颅C T A检查，查明畸形血管团的部位、大小、供血动脉和回流静脉后，再手术切除畸形血管团，清除血肿。结果18例畸形血管团全部切除，4例部分残留，死亡2例，偏瘫5例，失语4例，破入脑室者同时行脑室外引流2例。结论颅内动静脉畸形急性出血，为挽救病人生命急诊手术清除血肿并切除畸形血管团，手术风险极高，致残率高，术前尽可能明确畸形血管团情况后再手术治疗。
목적：총결로내동정맥기형급성출혈적치료방법。방법분석근4 a아원수치적22례로내동정맥기형급성출혈병인，16례인출혈량대，급진개로수술청제혈종병절제기형혈관단，6례출혈량교소적병인，선행두로C T A검사，사명기형혈관단적부위、대소、공혈동맥화회류정맥후，재수술절제기형혈관단，청제혈종。결과18례기형혈관단전부절제，4례부분잔류，사망2례，편탄5례，실어4례，파입뇌실자동시행뇌실외인류2례。결론로내동정맥기형급성출혈，위만구병인생명급진수술청제혈종병절제기형혈관단，수술풍험겁고，치잔솔고，술전진가능명학기형혈관단정황후재수술치료。
Objective To summarize the effective treatment of intracranial arteriovenous malformations (AVM ) with acute hemorrhage.Methods Twenty-two cases of AVM with acute hemorrhage were retrospectively analyzed since last 4 years. For 16 patients ,we had to make a emergency surgical operation to remove the hematoma and deformed blood vessel due to the large hematoma. Six patients had small hematoma ,first we did a head CTA inspection and ascertained the size of deformity arteriolar signal ,blood supply arteries and reflux vein ,then removed the hematoma and deformed arteriola with surgical operation. Re-sults Malformed arteriolar of 18 cases were totally removed ;malformed arteriolar of 4 cases were partially residual ;death in 2 cases ;hemiplegia in 5 cases ;aphasia in 4 cases. In 2 cases the hematoma broke into the ventricular system and extra ventricular drainage were performed simultaneously. Conclusion Acute hemorrhage secondary to intracranial arteriovenous malformation is very dangerous. In the case of not geting the message of the specific conditions of the deformity arteriolar ,making a emer-gency surgical operation to remove the hematoma and deformed arteriolar always has very high risk and higher morbidity for pa-tients. So we must clear the situation of the deformed arteriolar as much as possible before surgery.