自发性硬脑膜动静脉瘘诊断延误的相关因素及对预后的影响

发布时间：2019-02-12 23:10

【摘要】：【目的】探讨自发性硬脑膜动静脉瘘(DAVF)诊断延误的相关因素及对预后的可能影响。【方法】连续纳入102例在中山大学附属第一医院确诊为自发性DAVF患者。分析了诊断延误的相关因素及对治疗和预后的影响。预后为出院时症状是否痊愈、改善或无改善。【结果】从发病到确诊DAVF的中位时间为3个月(四分位数间距:1~6个月)。与诊断较早组(诊断时间≤3个月)相比,诊断较晚组(诊断时间3个月)头痛(P=0.012)、眼睑下垂(P=0.035)和颅内病灶(P=0.001)比例更低,结膜充血(P=0.004)、耳鸣(P=0.021)、视力障碍(P0.001)、孤立视力障碍(P=0.007)和较晚完成影像学检查(P0.001)比例更高,手术切除或夹闭病灶比例更低、血管内治疗比例更高(P=0.005),出院时症状已痊愈或改善比例更低(P=0.033),其中有视力障碍者痊愈或改善的比例较无视力障碍者更低(P=0.023)。与伴随其他症状的视力障碍者相比,孤立视力障碍患者以发作性黑朦或视朦起病(P0.001)、双眼受累(P0.001)和严重视力下降(P=0.057)比例更高,均有颅内高压[中位数(四分位数间距):405(370-512)mmH_2O],更多引流至横窦-乙状窦(P0.001)而非海绵窦(P0.001),但出院时痊愈或改善比例无差别(P=0.739)。【结论】诊断延误在自发性DAVF中是值得注意的,它会影响症状的改善,尤其是伴有视力障碍的患者。
[Abstract]:[objective] to investigate the factors related to the delayed diagnosis of spontaneous dural arteriovenous fistula (DAVF) and its possible influence on prognosis. [methods] 102 consecutive cases of spontaneous DAVF were diagnosed in the first affiliated Hospital of Sun Yat-sen University. The factors related to delayed diagnosis and its influence on treatment and prognosis were analyzed. The prognosis was whether the symptoms were cured, improved or not. [results] the median time from onset to diagnosis of DAVF was 3 months (quartile interval: 1 ~ 6 months). Compared with the earlier group (diagnosis time 鈮，

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