关键词: 脑动静脉畸形;血管内栓塞;手术

    摘 要:目的 探讨血管内栓塞联合手术切除治疗脑动静脉畸形的有效性. 方法 1999-03/2001-03采用血管内栓塞联合手术切除治疗脑动静脉畸形87例.79例以自发性颅内出血起病，4例为头痛，4例表现为癫痫.根据Spetzler-Martin计分标准，Ⅰ级9例，Ⅱ级11例，Ⅲ级12例，Ⅳ级43例，Ⅴ级12例.血管内栓塞剂为NBCA，栓后显微外科手术切除. 结果 通过血管内栓塞治疗，57例达到75%以上的闭塞率，占66%.AVM病灶闭塞在50%～75%者22例，占25%，闭塞率小于50%者8例，占9%.栓后手术完全切除病灶82例，占94%，次全或大部切除5例，占6%.术后3例遗留偏瘫或失语，死亡1例，术后并发症发生率为4.6%. 结论 血管内栓塞联合手术切除是治疗脑动静脉畸形的有效方法，特别是对大型动静脉畸形，治愈率高，致残率和死亡率低.

    Endovascular embolization combined surgery for87patients with cerebral arteriovenous malformations

    ZHAO Zhen-Wei，GAO Guo-Dong，QIN Huai-Zhou，LI Yong-Lin，ZHAO Ji-Pei，CHEN Ling Department of Neurosurgery，Tangdu Hospital，Fourth Military Medical University，Xi'an710038，China

    Keywords:cerebral arteriovenous malformation;endovascu-lar embolization;surgery

    Abstract:AIM To discuss the effect of endovascular em-bolization combined surgery for cerebral arteriovenous mal-formations(AVM).METHODS From March1997to March2001，87patients were treated by endovascular em-bolization combined surgery.79patients presented with spontaneous intracranial hemorrhage，4with headache， 4with seizure.According to Spetzler and Martin grading scale ......