脑动静脉畸形显微外科治疗的预后分析

发布时间：2018-04-15 01:01

本文选题：脑动静脉畸形 + 显微外科　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的:通过回顾36例脑动静脉畸形患者的临床资料,分析影响神经外科显微手术治疗脑动静脉畸形预后的相关因素。方法:回顾性分析2007年5月至2016年5月在我院神经外科住院行显微手术治疗的36例脑动静脉畸形患者,整理患者性别、年龄、出血量、病灶是否在功能区、有无引流静脉、病灶大小及S-M(Spetzler-Martin)分级及出院后6个月的GOS(Glasgow Outcome Scale)评分。应用单因素及Logistics多因素分析方法,筛选出对脑动静脉畸形显微外科治疗预后有影响的相关因素。结果:单因素分析提示深部引流静脉、位于功能区、病灶大小、S-M分级与预后有关。多因素分析提示病灶位置、大小及S-M分级是影响脑动静脉畸形显微外科治疗预后的独立危险因素。结论:显微外科手术是治疗脑动静脉畸形的重要方法,病灶全切率高,且有助于预防二次出血、提高患者生存质量。CTA、MRI及DSA可对AVM做出明确诊断,有助于术中定位,提高病灶全切率,减少术中出血及周围脑组织损伤等。S-M分级、病灶位置及畸形团大小均是影响显微外科手术治疗脑动静脉畸形患者预后的重要因素。对于S-M分级不同的患者,应根据具体情况,采取不同方法进行治疗。
[Abstract]:Objective: To review 36 cases of cerebral venous malformation in patients with clinical data, analysis of related factors affecting the prognosis of venous malformation microsurgery for cerebral Department of neurosurgery. Methods: a retrospective analysis from May 2007 to May 2016 hospitalized for microsurgery in 36 cases of patients with brain arteriovenous malformation in our hospital department of Neurosurgery, finishing with sex, age, the amount of bleeding whether, lesions in functional areas, there is no venous drainage, lesion size and S-M (Spetzler-Martin) GOS 6 months after discharge and grading (Glasgow Outcome Scale) score. Analysis by the single factor method and Logistics regression, to screen the related factors of cerebral venous malformation of microsurgical treatment and prognosis. Results: single factor analysis showed that deep venous drainage, located in functional areas, the size of the lesions, the S-M grading and prognosis. Multivariate analysis showed that lesion location, size and grade of S-M is brain movement Independent prognostic factors for AVM microsurgery. Conclusion: microsurgery is an important method for dynamic treatment of cerebral venous malformation, total lesion resection rate is high, and can help prevent two bleeding, improve the quality of life of patients with.CTA, MRI and DSA can make a definite diagnosis of AVM, contribute to the intraoperative positioning to improve the rate of total resection of lesions, reduce.S-M hemorrhage and surrounding brain tissue injury and other surgical classification, lesion location and malformation were important factors influencing the prognosis of patients with venous malformation microsurgery for cerebral S-M classification. For different patients, should according to the specific circumstances, adopt different methods of treatment.

【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12

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