【摘要】 目的分析巨大动静脉畸形综合治疗的随访结果 ,结合患者的临床资料对治疗方法及预后加以评估。方法对1995年9月—2006年12月在我院进行外科手术的121例巨大动静脉畸形患者进行随访,随访内容包括格拉斯哥预后评分(GOS)、神经功能缺失恢复情况、癫痫发作情况。结果 121例患者随访到85例,这85例患者动静脉畸形全切除率为100%,预后良好(GOS4分+5分)率为94.12%。术前有癫痫病史的37例患者,30例(81.08%)术后癫痫消失,为Ⅰ级;3例(8.11%)术后发作频率减少50%以上,为Ⅱ级;好转(WilliamsonⅠ级+Ⅱ级)率为89.19%,术前无癫痫史的48例患者,新发生癫痫8例(16.67%)。结论对于巨大动静脉畸形,综合治疗是最佳方案,术中栓塞加切除是首选方法 ,该方法可有效降低手术死亡率和致残率,提高患者的生存质量。更多还原

【Abstract】 Objective To analyze the follow-up results of combined therapy of huge arteriovenous malformation (AVM) to evaluate treatment and prognosis.Methods One hundred twenty-one AVM patients receiving surgical operation in our hospital from Septemper 1995 to December 2006 were followed up.The Glasgow Outcome Scales (GOS),the recovery of neurological deficits and seizures were observed.Results A total of 85 cases were followed up and the rate of AVM resection was 100%,good prognosis rate (5+4 GOS) was 94.1%.Among 37 patients with history of epilepsy before surgery,epilepsy disappeared in 30 (grading Ⅰ) after operation,postoperative seizure frequency reduced by more than 50% (grading Ⅱ) in 3.The improvement rate (Williamson Ⅰ+Ⅱ) was 89.19%.Forty-eight patients had not history of epilepsy before operation,new epilepsy onsets were noted in 8 after operation.Conclusion The combined therapy is the best option for huge AVM,and intraoperative embolization combined with removal is the first choice,which can reduce effectively operative mortality and disability rates and improve patients′ quality of life.更多还原