CAJ | 학술논문

目的：探讨颅内动静脉畸形（AVM）显微外科手术治疗方法和临床效果。方法选取手术治疗的90例颅内动静脉畸形患者，随机将其分为两组。对照组患者实行显微开颅切除手术，实验组患者实行显微下开颅切除手术联合术前栓塞术。比较两组患者的临床疗效、术后不良反应以及生活质量改善情况。结果实验组Ⅲ~Ⅴ级患者出血量显著低于对照组，Ⅲ级和Ⅳ级患者的完全切除率分别为90.00%、72.73%显著高于对照组的52.38%、45.45%，实验组Ⅲ~Ⅴ级 GOS评分显著高于对照组；实验组患者术后偏瘫（8.89%）、偏盲（4.45%）、脑神经功能障碍（2.22%）、癫痫（4.45%）的发生率显著低于对照组患者术后偏瘫（33.33%）、偏盲（28.89%）、脑神经功能障碍（22.22%）、癫痫（4.45%）的发生率；实验组患者的躯体功能、生理职能、身体疼痛以及总体健康评分显著高于对照组患者，差异均具有统计学意义（ P <0.05）。结论显微开颅手术与栓塞术的联合治疗颅内动静脉畸形可以有效改善临床效果，降低不良反应的发生，提高患者的生活质量。
목적：탐토로내동정맥기형（AVM）현미외과수술치료방법화림상효과。방법선취수술치료적90례로내동정맥기형환자，수궤장기분위량조。대조조환자실행현미개로절제수술，실험조환자실행현미하개로절제수술연합술전전새술。비교량조환자적림상료효、술후불량반응이급생활질량개선정황。결과실험조Ⅲ~Ⅴ급환자출혈량현저저우대조조，Ⅲ급화Ⅳ급환자적완전절제솔분별위90.00%、72.73%현저고우대조조적52.38%、45.45%，실험조Ⅲ~Ⅴ급 GOS평분현저고우대조조；실험조환자술후편탄（8.89%）、편맹（4.45%）、뇌신경공능장애（2.22%）、전간（4.45%）적발생솔현저저우대조조환자술후편탄（33.33%）、편맹（28.89%）、뇌신경공능장애（22.22%）、전간（4.45%）적발생솔；실험조환자적구체공능、생리직능、신체동통이급총체건강평분현저고우대조조환자，차이균구유통계학의의（ P <0.05）。결론현미개로수술여전새술적연합치료로내동정맥기형가이유효개선림상효과，강저불량반응적발생，제고환자적생활질량。
Objective To analyze the intracranial arteriovenous malformation(AVM)micro surgical operation treatment method and clinical effect. Methods 90 cases of intracranial venous malformation were included into this study. All patients received operation treatment in our hospi-tal. All patients were grouped according to the method of treatment,patients in the control group received microsurgical resection operation,patients in the control group under the implementation of micro craniotomy for operation combined with preoperative embolization. The clinical effect was com-pared between two groups of patients,and including postoperative adverse reactions and the improvement of the quality of life. Results The bleeding volume in experimental group III ~ V level patients was significantly lower than the control group. The patients with completely resected III and IV rates were completely removed in 90. 00% ,72. 73% ,which were significantly higher than that of control group III and IV patients rate respectively is 52. 38% ,45. 45% . III ~ V grade GOS scores were significantly higher than that of the control group. The patients of experiment groups with hemi-plegia(8. 89% ),hemianopia(4. 45% ),cranial nerve dysfunction(2. 22% ),epilepsy(4. 45% )was significantly lower than those in control group,the incidence of postoperative patients with hemiplegia(33. 33% ),hemianopia(28. 89% ),cranial nerve dysfunction(22. 22% ),the inci-dence of epilepsy(4. 45% ). The physical function,role physical,bodily pain,general health scores in the patients in the experimental group were significantly higher than that of the control group of patients,the difference was statistically significant( P < 0. 05). Conclusion The combined treatment of micro craniotomy and embolization can effectively improve the clinical effect and reduce the occurrence of adverse reactions and improve the quality of life of patients,and has important application value in clinic.