摘要
目的探讨基于单元结构分型的颅内动静脉畸形(AVM)血管内治疗的疗效。方法回顾性分析2017年2月至2020年12月广东省人民医院(广东省医学科学院)神经外科收治的458例颅内AVM患者的临床资料。根据本组既往对颅内AVM单元结构的研究,对颅内AVM病变进行分型(多发病变者以责任病变统计),其中Ⅰ型32例、Ⅱ型37例、Ⅲ型45例、Ⅳ型109例、Ⅴ型235例。根据不同分型采用个体化的血管内治疗方法,总结其治疗效果和安全性。结果458例患者的总体治愈率为44.3%(203/458)(95%CI:0.40~0.49),其中Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ型患者的治愈率分别为84.4%(27/32)、94.6%(35/37)、95.6%(43/45)、31.2%(34/109)以及27.2%(64/235)。术后总体功能相关并发症的发生率为6.1%(28/458)(95%CI:0.04~0.08),其中技术性、出血性和缺血性并发症分别为7例(25.0%)、4例(14.3%)和17例(60.7%)。结论基于单元结构,颅内AVM可分为5种类型,参考此分型采取个体化血管内治疗,可获得较好的疗效,且并发症少。
Objective To explore the efficacy of endovascular therapy based on the new classification of unit structure of the intracranial arteriovenous malformations(AVM).Methods A retrospective analysis was conducted on the clinical data of 458 patients with intracranial AVM admitted to the Department of Neurosurgery,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences)from February 2017 to December 2020.According to the unit structure classification method developed in our previous study,intracranial AVM were classified and included 32 cases of typeⅠ,37 cases of typeⅡ,45 cases of typeⅢ,109 cases of typeⅣ,and 235 cases of typeⅤ.Individualized endovascular treatment methods were used according to different types,and their therapeutic effects and safety were summarized.Results The overall cure rate of 458 patients was 44.3%(95%CI:0.40-0.49).In this series,the cure rates of typesⅠ,Ⅱ,Ⅱ,Ⅳ,andⅤwere 84.4%(27/32)and 94.6%(35/37),95.6%(43/45),31.2%(34/109)and 27.2%(64/235).The incidence of postoperative overall dysfunctional complications was 6.1%(28/458)(95%CI:0.04-0.08).Specifically,there were 7 cases of technical complications(25.0%),4 cases of hemorhagic complications(14.3%)and 17 cases of ischemic complications(60.7%).Conclusion Based on the unit structure,intracranial AVM can be divided into five types,and individualized endovascular treatment with reference to this classification has relatively good efficacy and few complications.
作者
陈光忠
洪川
秦琨
彭超
陈圣攀
王坤
Chen Guangzhong;Hong Chuan;Qin Kun;Peng Chao;Chen Shengpan;Wang Kun(Department of Neurosurgery,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Guangzhou 510280,China;the Second School of Clinical Medicine,Southerm Medical University,Guangzhou 510280,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2022年第4期363-367,共5页
Chinese Journal of Neurosurgery
关键词
颅内动静脉畸形
血管内操作
治疗结果
单元结构
新分型
Intracranial arteriovenous malformation
Endovascular procedures
Treatment outcome
Structural typing:unit
New typing method
