CAJ | 학술논문

目的评价Onyx介入栓塞联合显微手术治疗脑动静脉畸形(BAVM)的临床应用价值.方法应用Onyx血管内介入栓塞联合显微手术治疗48例BAVM,记录病例的临床特征、治疗经过和相关并发症,出院前复查MRI和DSA,GOS预后量表评估出院情况;随访采用改良Rankin评分(mRS)评价预后.结果手术全切除47例(97.9％),发生治疗相关并发症8例(16.7％):神经功能损伤4例(8.3％),包括2例肢体运动功能障碍、1例运动性失语和1例明显的视野缺损;术后出血2例(4.2％);严重脑水肿2例(4.2％);其余40例(83.3％)患者治疗后情况比入院时改善或持平.出院的GOS评分恢复良好38例(79.2％);随访6～42个月的mRS评分小于3分47例(97.9％).结论 Onyx介入栓塞联合显微手术切除BAVM可以取得理想的临床疗效.
목적 평개Onyx개입전새연합현미수술치료뇌동정맥기형(BAVM)적림상응용개치.방법 응용Onyx혈관내개입전새연합현미수술치료48례BAVM,기록병례적림상특정、치료경과화상관병발증,출원전복사MRI화DSA,GOS예후량표평고출원정황;수방채용개량Rankin평분(mRS)평개예후.결과 수술전절제47례(97.9％),발생치료상관병발증8례(16.7％):신경공능손상4례(8.3％),포괄2례지체운동공능장애、1례운동성실어화1례명현적시야결손;술후출혈2례(4.2％);엄중뇌수종2례(4.2％);기여40례(83.3％)환자치료후정황비입원시개선혹지평.출원적GOS평분회복량호38례(79.2％);수방6～42개월적mRS평분소우3분47례(97.9％).결론 Onyx개입전새연합현미수술절제BAVM가이취득이상적림상료효.
Objective To evaluate the clinical application of multimodality treatment of brain arteriovenous malformation (BAVM) with Onyx embolization and microsurgery.Methods There were 48 patients with BAVM treated by combination of Onyx embolization and microsurgery.The clinical features,therapeutic process,complications and discharge status (by MRI,DSA and Glasgow outcome scale,GOS) were recorded in detail.The prognosis was estimated by modified Rankin scale (mRS) with 6-42 months' follow-up.Results The total resection rate was 97.9％.The therapy-related complications happened in 8 patients (16.7％).Among them,4 cases had dysfunction of central nervous system (8.3％),2 cases with intra-cerebral hemorrhage (4.2％),and 2 suffered from severe cerebral edema (4.2％).Good recovery was seen in 38 cases (79.2％) evaluated by GOS when discharged from hospital.The follow-up result mRS ＜ 3 was 97.9％.Conclusion Multimodality treatment of BAVM with Onyx embolization and microsurgery should be a good therapeutic strategy.