直接手术与血管内超选择栓塞术治疗颅内动静脉畸形的临床效果
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摘要
目的比较直接手术与血管内超选择栓塞术治疗颅内动静脉畸形的临床效果。方法选择本院2015年1月至2017年5月收治的80例颅内动静脉畸形患者为研究对象,按随机数字表法将其分为手术组与介入组,各40例。手术组给予显微外科手术,介入组给予血管内超选择栓塞术。比较两组一、二期治愈率、复发率、并发症总发生率及临床预后良好率。结果手术组一期治愈率为95.00%,高于介入组的47.37%,差异具有统计学意义(P<0.05)。手术组与介入组复发率分别为2.50%与10.53%,两组比较,差异无统计学意义(P>0.05)。手术组与介入组并发症总发生率分别为12.50%与15.79%,两组比较,差异无统计学意义(P>0.05)。手术组与介入组的临床预后良好率分别为92.50%与92.11%,两组比较,差异无统计学意义(P>0.05)。结论 S-M静脉畸形患者,治愈率高于血管内超选择栓塞术,且术后并发症总发生率较低,值得临床推广。
Objective To compare the clinical effect of direct operation and intravascular superselective embolization in the treatment of intracranial arteriovenous malformations. Methods Eighty patients with intracranial arteriovenous malformations admitted in our hospital from January 2015 to May 2017 were selected as the study objects. They were divided into operation group and intravascular intervention group according to random number table method, with 40 cases in each group. Microsurgery was performed in the operation group and superselective embolization was performed in the intervention group. The primary and secondary cure rate, recurrence rate, total incidence of complications and good rate of clinical prognosis of the two groups were compared. Results The primary cure rate of the operation group was 95.00%,which was higher than 47.37% of the intervention group(P <0.05). The recurrence rates of the operation group and the intervention group were 2.50% and 10.53% respectively, and there was no significant difference between the two groups(P>0.05). The total incidence of complications was 12.50% in the operation group and 15.79% in the intervention group,there was no significant difference between the two groups(P>0.05). The good rates of clinical prognosis in the operation group and the intervention group were 92.50% and 92.11% respectively, and there was no significant difference between the two groups(P>0.05). Conclusion Microsurgery in the treatment of intracranial arteriovenous malformations with S-M grade Ⅰ to Ⅲ has higher cure rate than intravascular superselective embolization, and has lower total incidence of complications, which is worthy of clinical promotion.
Objective To compare the clinical effect of direct operation and intravascular superselective embolization in the treatment of intracranial arteriovenous malformations. Methods Eighty patients with intracranial arteriovenous malformations admitted in our hospital from January 2015 to May 2017 were selected as the study objects. They were divided into operation group and intravascular intervention group according to random number table method, with 40 cases in each group. Microsurgery was performed in the operation group and superselective embolization was performed in the intervention group. The primary and secondary cure rate, recurrence rate, total incidence of complications and good rate of clinical prognosis of the two groups were compared. Results The primary cure rate of the operation group was 95.00%,which was higher than 47.37% of the intervention group(P <0.05). The recurrence rates of the operation group and the intervention group were 2.50% and 10.53% respectively, and there was no significant difference between the two groups(P>0.05). The total incidence of complications was 12.50% in the operation group and 15.79% in the intervention group,there was no significant difference between the two groups(P>0.05). The good rates of clinical prognosis in the operation group and the intervention group were 92.50% and 92.11% respectively, and there was no significant difference between the two groups(P>0.05). Conclusion Microsurgery in the treatment of intracranial arteriovenous malformations with S-M grade Ⅰ to Ⅲ has higher cure rate than intravascular superselective embolization, and has lower total incidence of complications, which is worthy of clinical promotion.
引文
[1]杨松柳,张大明,金松根,等.32例脑动静脉畸形未手术治疗患者的随访与观察[J].现代生物医学进展,2017,17(28):5590-5593.
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[5]孙锦章,赵兵,江涛,等.神经导航联合术中超声辅助显微手术治疗幕上颅内动静脉畸形[J].中国脑血管病杂志,2018,15(6):309-312.
[6]张印松,张海峰,董玉书,等.未破裂颅内动静脉畸形患者生命质量及其影响因素分析[J].中华神经外科杂志,2018,34(5):515-518.
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[9]霍晓川,李佑祥,江裕华,等.Onyx胶栓塞结合伽玛刀治疗颅内动静脉畸形的疗效分析[J].中华神经外科杂志,2015,31(11):1126-1130.
[10]诸德源,方亦斌,黄清海,等.血管内栓塞结合二期立体定向放射外科治疗颅内动静脉畸形的效果[J].中国脑血管病杂志,2016,13(3)123-127.
[11]崔德秋,曾高,杜建新,等.儿童颅内动静脉畸形的外科治疗研究进展[J].中国脑血管病杂志,2017,14(10):551-556.
[12]严敏,詹仁雅.脑动静脉畸形的研究进展[J].国际神经病学神经外科学杂志,2006,33(5):421-424.
[13]张绪新,孙丕通,邓东风,等.特大型颅内动静脉畸形显微外科手术治疗的临床分析[J].中华医学杂志,2016,96(5):361-363.
[14]蒋宇钢,张明铭,李奇,等.颅内动静脉畸形显微外科手术治疗策略[J].中华显微外科杂志,2013,36(5):426-430.
[15]曲艺,牟壮,朱健.颅内动静脉畸形显微外科手术治疗的方法与效果[J].临床和实验医学杂志,2015,14(9):707-710.
[16]李珉,陈高,胡未伟,等.血管内栓塞联合显微外科手术治疗脑动静脉畸形的临床研究[J].浙江医学,2004,26(1):9-11.
[2]尹剑,赖凌峰,张炘,等.儿童颅内动静脉畸形破裂出血的危险因素分析及血管内栓塞治疗体会[J].中华神经医学杂志,2016,15(11)1136-1141.
[3]诸德源,方亦斌,刘建民,等.血管内介入栓塞联合伽马刀治疗颅内动静脉畸形的研究进展[J].中国脑血管病杂志,2017,14(7):390-393.
[4]张晓峰,零达尚,林其炎,等.急诊显微手术治疗在42例颅内动静脉畸形破裂出血患者中的应用体会[J].贵州医药,2018,42(5):573-574.
[5]孙锦章,赵兵,江涛,等.神经导航联合术中超声辅助显微手术治疗幕上颅内动静脉畸形[J].中国脑血管病杂志,2018,15(6):309-312.
[6]张印松,张海峰,董玉书,等.未破裂颅内动静脉畸形患者生命质量及其影响因素分析[J].中华神经外科杂志,2018,34(5):515-518.
[7]刘俊,宋海·别德勒汗,张华楸,等.影响颅内动静脉畸形显微手术患者预后的出血性因素分析[J].中国脑血管病杂志,2017,14(12):617-621.
[8]葛云鹏,张鸿祺.术前栓塞联合显微外科手术治疗颅内动静脉畸形的效果分析[J].中国脑血管病杂志,2017,14(3):145-148,158.
[9]霍晓川,李佑祥,江裕华,等.Onyx胶栓塞结合伽玛刀治疗颅内动静脉畸形的疗效分析[J].中华神经外科杂志,2015,31(11):1126-1130.
[10]诸德源,方亦斌,黄清海,等.血管内栓塞结合二期立体定向放射外科治疗颅内动静脉畸形的效果[J].中国脑血管病杂志,2016,13(3)123-127.
[11]崔德秋,曾高,杜建新,等.儿童颅内动静脉畸形的外科治疗研究进展[J].中国脑血管病杂志,2017,14(10):551-556.
[12]严敏,詹仁雅.脑动静脉畸形的研究进展[J].国际神经病学神经外科学杂志,2006,33(5):421-424.
[13]张绪新,孙丕通,邓东风,等.特大型颅内动静脉畸形显微外科手术治疗的临床分析[J].中华医学杂志,2016,96(5):361-363.
[14]蒋宇钢,张明铭,李奇,等.颅内动静脉畸形显微外科手术治疗策略[J].中华显微外科杂志,2013,36(5):426-430.
[15]曲艺,牟壮,朱健.颅内动静脉畸形显微外科手术治疗的方法与效果[J].临床和实验医学杂志,2015,14(9):707-710.
[16]李珉,陈高,胡未伟,等.血管内栓塞联合显微外科手术治疗脑动静脉畸形的临床研究[J].浙江医学,2004,26(1):9-11.