CAJ | 학술논문

目的：探讨影响脑动静脉畸形（cAVM）栓塞术后颅内出血的高危因素。方法回顾性分析经过畸形血管团栓塞治疗的230例脑动脉畸形患者的临床资料，记录术后3 d 内颅内出血的发生情况，采用非条件 Logistic 回归法统计分析术后颅内出血的高危因素。结果术后共有15例患者出现颅内出血，治疗后畸形血管团面积为（2．18±0．91）cm，与治疗前（6．67±1．56）cm 相比患者畸形血管团面积明显缩小（t ＝9．627， P ＜0．05）。Logistic 回归分析显示患者的年龄、性别、出血史、癫痫史、SM分级及 cAVM大小与术后颅内出血无关（均 P ＞0．05），单次栓塞面积≥36．5％（P ＝0．031）和患者有既往高血压史（P ＝0．025）是栓塞术后患者颅内出血的高危因素。结论患者单次栓塞面积过大（≥36．5％）或术前有高血压史可诱发脑动静脉畸形栓塞术后颅内出血，密切观察血管栓塞情况，术后3 d 内严格降低患者血压对预防患者术后继发颅内出血有一定帮助。
목적：탐토영향뇌동정맥기형（cAVM）전새술후로내출혈적고위인소。방법회고성분석경과기형혈관단전새치료적230례뇌동맥기형환자적림상자료，기록술후3 d 내로내출혈적발생정황，채용비조건 Logistic 회귀법통계분석술후로내출혈적고위인소。결과술후공유15례환자출현로내출혈，치료후기형혈관단면적위（2．18±0．91）cm，여치료전（6．67±1．56）cm 상비환자기형혈관단면적명현축소（t ＝9．627， P ＜0．05）。Logistic 회귀분석현시환자적년령、성별、출혈사、전간사、SM분급급 cAVM대소여술후로내출혈무관（균 P ＞0．05），단차전새면적≥36．5％（P ＝0．031）화환자유기왕고혈압사（P ＝0．025）시전새술후환자로내출혈적고위인소。결론환자단차전새면적과대（≥36．5％）혹술전유고혈압사가유발뇌동정맥기형전새술후로내출혈，밀절관찰혈관전새정황，술후3 d 내엄격강저환자혈압대예방환자술후계발로내출혈유일정방조。
Objective To study the risk factors of intracranial hemorrhage after endovascular therapy of cere-bral arteriovenous malformations embolization.Methods the clinical records and images of 230 patients with cAVMs were retrospectively reviewed.Patients with intracranial hemorrhage after endovascular therapy in 3 days were recorded and the risk factors of hemorrthage by using multivariate logistic regression for guiding the treatment strategy were studied.Results There were 15 patients occurred intracerebral hemorrhages.After treatment the area of cAVMs was significantly smaller than that before treatment[(2.18 ±0.91)cm vs (6.67 ±1.56)cm],the difference lvas a statis-tically significant (t =9.627,P <0.05).A partial AVM reduction of ≥36.5%(P =0.031)and hypertension(P =0.025)were considered as risk factors for hemorrhage after endovascular therapy of cAVWs.Conclusion Patients receives a partial AVMreduction of ≥36.5% or with hypertension history have a tendancy of increasing hemorrhage after endovascular therapy of cAVMs.It's helpful for preventing intracerebral hemorrhage if the arterial blood pressure maintains after endovascular therapy.