脑动静脉畸形破裂出血的危险因素分析
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摘要
目的探讨脑动静脉畸形(AVM)破裂出血发生的危险因素。方法回顾性研究2014年—2018年我院收治的AVM病例42例,根据有无破裂出血,分为出血组和非出血组,对AVM破裂出血发生的相关因素进行统计学分析。结果通过相关性及逐步回归分析,表明AVM破裂出血的独立危险因素为:深部静脉引流和低龄患者。结论对于引流静脉为深部静脉引流类型和低龄的AVM患者,应积极尽早治疗。
Objective To analyze the risk factors related to cerebral arteriovenous malformation(AVM)with hemorrhage. Methods The clinical data of 42 patients with AVM between 2014 and 2018 were respectively studied. According to the presence of rupture, the cases were divided into bleeding group and non-bleeding group. The factors associated with the occurence of AVM rupture were statistically analyzed. Results The correlation and logistic regression analysis suggested that the deep venous drainage and young patients were the independent risk factors for AVM rupture. Conclusion The young patients and the patients with deep venous drainage should be operated as soon as possible to avoid hemorrhage.
Objective To analyze the risk factors related to cerebral arteriovenous malformation(AVM)with hemorrhage. Methods The clinical data of 42 patients with AVM between 2014 and 2018 were respectively studied. According to the presence of rupture, the cases were divided into bleeding group and non-bleeding group. The factors associated with the occurence of AVM rupture were statistically analyzed. Results The correlation and logistic regression analysis suggested that the deep venous drainage and young patients were the independent risk factors for AVM rupture. Conclusion The young patients and the patients with deep venous drainage should be operated as soon as possible to avoid hemorrhage.
引文
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[13] STAPF C,MOHR J P,PILE-SPELLMAN J,et al.Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation [J].J Neurol Neurosurg Psychiatry,2002,73(3):294-298.
[14] DING D.Pathogenesis of radiosurgery-induced cyst formation in patients with cerebral arteriovenous malformations [J].Acta Neurchir(Wien),2015,157(5):775-777.
[2] KIM H AI-SHAHI S R,MCCULLOCH C E.Untreated brain arteriovenous malformation:patient-level meta-analysis of hemorrhage predictors [J].Neurol,2014,83(7):590-597.
[3] MOHR J P,PARIDES M K,STAPF C.Medical management with or without interventional therapy for unruptured brain arteriovenous malformations(ARUBA):a multicentre,non-blinded,randomized trial [J].Lancet,2014,383(9917):614- 621.
[4] GROSS B A,DU R.Natural history of cerebral arteriovenous malformations:a meta-analysis [J].J Neurosurg,2013,118 (2):437- 443.
[5] PORRAS J L,YANG W,PHILADELPHIA E,et al.Hemorrhage risk of brain arteriovenous malformations during pregnancy and puerperium in a north american cohort [J].Stroke,2017,48(6):1507-1513.
[6] 郭鹏,赵继宗.脑动静脉畸形 3094 例的临床特征及外科治疗效果分析 [J].中华医学杂志,2011,91(39):2740-2743.
[7] YAMADA S,TAKAGI Y,NOZAKI K,et al.Risk factors forsubsequent hemorrhage in patients with cerebral arteriovenous malformations [J].J Neurosurg,2007,107(5):965-972.
[8] STAPF C,MAST H,SCIACCA R R,et al.Predictors of hemorrhage in patients with untreated brain arteriovenous malformation [J].Neurol,2006,66(9):1350-1355.
[9] BURKHARDT J K,CHEN X,WINKLER E A,et al.Delayed venousdrainage in ruptured arteriovenous malformations based on quantitative color-coded digital subtraction angiography [J].World Neurosurg,2017,104(8):619- 627.
[10] 王志刚,张纪庆,等.脑动静脉畸形出血的血管构筑学因素探讨 [J].山东大学学报(医学版),2007,45(4):389-392.
[11] HEINTEL T M,BERGLEHNER A,MEFFERT R.Accuracy of percutaneous pedicle screws for thoracic and lumbar spine fractures:aprospetive trial [J].Eur Spine J,2013,22(3):495-502.
[12] KUBALEK R,MOGHTADERI A,KLISCH J.Cerebral arteriovenous malformations:influence of angioarchitecture on bleeding risk [J].Acta Neurochir,2003,145(12):1045-1052.
[13] STAPF C,MOHR J P,PILE-SPELLMAN J,et al.Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation [J].J Neurol Neurosurg Psychiatry,2002,73(3):294-298.
[14] DING D.Pathogenesis of radiosurgery-induced cyst formation in patients with cerebral arteriovenous malformations [J].Acta Neurchir(Wien),2015,157(5):775-777.