CAJ | 학술논문

目的：探讨儿童期脑动静脉畸形（AVM）破裂出血急性期的确诊方式、显微外科治疗时机与急性期手术治疗效果。方法对2003～2013年收治的72例儿童（≤16岁）AVM出血患者临床资料进行回顾性分析。结果 CT确诊率为48．6％（35/72），MRI确诊率78．3％（47/60）。对条件允许的56例患者行早期全脑脑血管造影（DSA）检查，确诊率为98．2％（55/56）。72例患者均在出血急性期行显微镜下血肿清除及针对性病灶切除术，70例患者术后围术期复查 DSA/CT血管造影（CTA）/磁共振血管造影（MRA），病灶切除率为91．4％，部分切除率为8．6％。围术期死亡2例，70例存活患者中60例（85．7％）患者获得随访6个月至6年，按照 GOS评定：5分55例，4分2例，3 分2例，2分1例。结论 DSA是儿童 AVM出血早期诊断主要的检查手段；急性期显微手术可降低出血病死率和改善预后。
목적：탐토인동기뇌동정맥기형（AVM）파렬출혈급성기적학진방식、현미외과치료시궤여급성기수술치료효과。방법대2003～2013년수치적72례인동（≤16세）AVM출혈환자림상자료진행회고성분석。결과 CT학진솔위48．6％（35/72），MRI학진솔78．3％（47/60）。대조건윤허적56례환자행조기전뇌뇌혈관조영（DSA）검사，학진솔위98．2％（55/56）。72례환자균재출혈급성기행현미경하혈종청제급침대성병조절제술，70례환자술후위술기복사 DSA/CT혈관조영（CTA）/자공진혈관조영（MRA），병조절제솔위91．4％，부분절제솔위8．6％。위술기사망2례，70례존활환자중60례（85．7％）환자획득수방6개월지6년，안조 GOS평정：5분55례，4분2례，3 분2례，2분1례。결론 DSA시인동 AVM출혈조기진단주요적검사수단；급성기현미수술가강저출혈병사솔화개선예후。
Objective To investigate the diagnostic method,microsurgical operation time and effect of brain arteriovenous mal-formation(AVM)rupture hemorrhage in childhood.Methods 72 children (≤16 years old)of AVM hemorrhage from 2003 to 2013 were retrospectively analyzed.Results The CT diagnosis rate was 48.6%(35/72),the MRI diagnosis rate was 78.3%(47/60),56 cases were performed the early whole brain DSA under the condition permitting,its diagnosis rate was 98.2%(55/56).All the cases were performed the hematoma clearance plus the pertinent lesion resection.70 cases were re-examined by DSA/CTA/MRA during postoperative perioperation period.The lesion resection rate was 91.5%,the partial resection rate was 8.6%.60 cases(85.7%) were successfully followed up for 6 months to 6 years and assessed by the Glasgow outcome scale,5 points in 5 5 cases,4 points in 2 cases,3 points in 2 cases and 2 points in 1 cases.Conclusion DSA is the main detection measure for early diagnosing AVM hem-orrhage and the microsurgical operation in the acute stage can reduce the fatality and improve the prognosis.