[1]徐田明　蔡栋阳　薛绛宇　贺迎坤　李天晓.复合手术治疗硬脊膜动静脉瘘31例分析[J].中国临床神经外科杂志,2020,(10):664-666.[doi:10.13798/j.issn.1009-153X.2020.10.002]
　XU Tian-ming,CAI Dong-yang,XUE Jiang-yu,et al.Hybrid operation for spinal dural arteriovenous fistulas (report of 31 cases)[J].,2020,(10):664-666.[doi:10.13798/j.issn.1009-153X.2020.10.002]
点击复制

复合手术治疗硬脊膜动静脉瘘31例分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年10期
页码:
664-666
栏目:
论著
出版日期:
2020-10-25

文章信息/Info

Title:
Hybrid operation for spinal dural arteriovenous fistulas (report of 31 cases)
文章编号:
1009-153X（2020）10-0664-03
作者:
徐田明　蔡栋阳　薛绛宇　贺迎坤　李天晓
450003 郑州，河南大学河南省人民医院介入中心（徐田明、蔡栋阳、薛绛宇、贺迎坤、李天晓）
Author(s):
XU Tian-ming;  CAI Dong-yang;  XUE Jiang-yu;  HE Ying-kun;  LI Tian-xiao.
Centre for Interventional Therapy, Henan Provincial People’s Hospital of Henan University, Zhengzhou 450003, China
关键词:
硬脊膜动静脉瘘; 复合手术; 疗效
Keywords:
Spinal dural arteriovenous fistulas;  Hybrid operation;  Curative effect
分类号:
R 744.1; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2020.10.002
文献标志码:
A
摘要:
目的 探讨复合手术治疗硬脊膜动静脉瘘（SDAVF）的疗效。方法 回顾性分析2014年8月至2019年7月复合手术治疗的31例SDAVF的临床资料。术中DSA技术定位瘘口，据造影结果调整动脉夹，并验证瘘口闭塞的安全性和准确性。术后平均随访（28.9±2.7）个月，采用Aminoff-Logue评分（ALS）评价脊髓功能。结果 31例瘘口位置均准确定位，无扩大切口以暴露病灶，术后造影显示瘘口均消失。末次随访ALS[（3.3±0.5）分]较术前[（4.4±0.5）分]明显降低（P<0.05）；好转14例，无变化4例，加重2例，好转率为66.7%。随访期间无复发病例。结论 复合手术SDAVF安全、有效，与血管内栓塞相比，解决了其早期失败率及晚期复发率高的问题；与显微手术相比，实现了术中精准定位及实时效果评价。
Abstract:
Objective To summarize the experience in treating spinal dural arteriovenous fistulas (SDAVF) using hybrid operation. Methods A retrospective analysis was performed on 31 patients with SDAVF who received hybrid operation from August 2014 to July 2019. Intraoperative DSA was used to locate the fistula. During the clipping, the clips was adjusted and the safety and accuracy of fistula occlusion were verified by intraoperative angiography. The mean follow-up time after surgery was (28.9±2.7) months, Aminoff-logue score (ALS) for myelopathy was used to evaluate the spinal function. Results All the fistulas were accurately located in 31 patients by intraoperative DSA. No one needed to enlarge the incision to expose the lesion. The fistulas disappeared in all the patiets. The ALS at last follow-up [(3.3±0.5) points] was significantly higher than that [(4.4±0.5) points] before operation (P<0.05). No fitulas recured during the follow-up. Conclusions Hybrid operation is a safe and effective treatment method for patients with SDAVF. Compared with endovascular embolization, hybrid operation can solve the problem of high early failure rate and late recurrence rate. Compared with microsurgery, hybrid operation can achieve precise intraoperative positioning and real-time effect evaluation.

参考文献/References:

[1] Sanborn MR, Crowley RW, Uschold T, et al. Spinal dural arteriovenous fistulas: how, when, and why [J]. Neurosur-gery, 2014, 61 Suppl 1: 6-11.
[2] 蔡明俊，马廉亭，杨　铭，等. 硬脊膜动静脉瘘的治疗分析[J]. 中国临床神经外科杂志，2018，23（6）：392-394.
[3] 杨　震，赵振伟，邓剑平，等. 硬脊膜动静脉瘘血管内栓塞治疗效果评估[J]. 中国临床神经外科杂志，2014，19（5）：263-265.
[4] Goyal A, Cesare J, Lu VM, et al. Outcomes following surgicalversus endovascular treatment of spinal dural arteriovenous fistula: a systematic review and meta-analysis [J]. J Neurol Neurosurg Psychiatry, 2019, 90(10): 1139-1146.
[5] Ren Y, Liu H, Chen TY, et al. Successful management of sacral dural arteriovenous fistulas: a case series and litera-ture review [J]. World Neurosurg, 2019, 126: 164-170.
[6] Marcus J, Schwarz J, Singh IP, et al. Spinal dural arteriove-nous fistulas: a review [J]. Curr Atheroscler Rep, 2013, 15(7): 335.
[7] Krings T, Geibprasert S. Spinal dural arteriovenous fistulas [J]. AJNR Am J Neuroradiol, 2009, 30(4): 639-648.
[8] Donghai W, Ning Y, Peng Z, et al. The diagnosis of spinal dural arteriovenous fistulas [J]. Spine (Phila Pa 1976), 2013,38(9): E546-553.
[9] Zhong W, Zhang J, Shen J, et al. Dural arteriovenous fistulasat the craniocervical junction: a series case report [J]. WorldNeurosurg, 2019, 122: e700-e712.
[10] Huntoon K, Khandpur U, Dornbos D, et al. Spinal dural arteriovenous fistula masquerading as subdural hematoma [J]. Surg Neurol Int, 2020, 11: 142.
[11] Day AL, Turkmani AH, Chen PR. Spinal arteriovenous fis-tulae: surgical management [J]. Handb Clin Neurol, 2017, 143: 189-198.
[12] Brown PA, Zomorodi AR, Gonzalez LF. Endovascular mana-gement of spinal dural arteriovenous fistulas [J]. Handb Clin Neurol, 2017, 143: 199-213.
[13] Steinmetz MP, Chow MM, Krishnaney AA, et al. Outcome after the treatment of spinal dural arteriovenous fistulae: a contemporary single-institution series and meta-analysis [J]. Neurosurgery, 2004, 55(1): 77-88.
[14] Bakker NA, Uyttenboogaart M, Luijckx GJ, et al. Recurrence rates after surgical or endovascular treatment of spinal dural arteriovenous fistulas: a meta-analysis [J]. Neurosur-gery, 2015. 77(1): 137-144.
[15] Open and endovascular treatment of spinal dural arteriove-nous fistulas: a 10-year experience [J]. J Neurosurg Spine, 2017, 26(4): 519-523.
[16] Zhang N, Xin WQ. Application of hybrid operating rooms fortreating spinal dural arteriovenous fistula [J]. World J Clin Cases, 2020, 8(6): 1056-1064.
[17] Marquardt G, Berkefeld J, Seifert V, et al. Preoperative coil marking to facilitate intraoperative localization of spinal dural arteriovenous fistulas [J]. Eur Spine J, 2009, 18(8): 1117-1120.
[18] Hanel RA, Nakaji P, Spetzler RF. Use of microscope-inte-grated near-infrared indocyanine green videoangiography inthe surgical treatment of spinal dural arteriovenous fistulae [J]. Neurosurgery, 2010, 66(5): 978-984.
[19] Schuette AJ, Cawley CM, Barrow DL. Indocyanine green videoangiography in the management of dural arteriovenous fistulae [J]. Neurosurgery, 2010, 67(3): 658- 662.
[20] 孙蔚宇，刘　静，潘智勇，等. 双C臂复合手术室行脑血管病复合手术的手术布局与术式切换[J]. 中国临床神经外科杂志，2020，25（7）：464-467.
[21] 张施远，蒋永明，曾　春，等. 复合手术在脑动静脉畸形治疗中的应用[J]. 中国临床神经外科杂志，2018，23（12）：779-781.

相似文献/References:

[1]曾　春　张施远　蒋永明.复合手术与常规夹闭术治疗颈内动脉后交通动脉破裂动脉瘤的疗效对比研究[J].中国临床神经外科杂志,2016,(05):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
　ZENG Chun,ZHANG Shi-yuan,JIANG Yong-ming.Analysis of the effects of hybrid surgery on posterior communicating artery aneurysms: a comparison with conventional craniotomy[J].,2016,(10):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
[2]伍　杰　杨　铭　潘　力　蔡明俊　刘　鹏　秦　杰　杨　柳　安学锋　李国栋　马廉亭.颅内破裂动脉瘤合并脑内血肿的复合手术治疗[J].中国临床神经外科杂志,2016,(04):193.[doi:10.13798/j.issn.1009-153X.2016.04.001]
　WU Jie,YANG Ming,PAN Li,et al.Clinical observation of hybrid surgery on ruptured intracranial aneurysms associated with cerebral hematomas (report of 5 cases)[J].,2016,(10):193.[doi:10.13798/j.issn.1009-153X.2016.04.001]
[3]胡　娜　厉春林　章　帆.全程护理在1例胸椎硬脊膜动静脉瘘患者的实施与评价[J].中国临床神经外科杂志,2015,(12):759.[doi:10.13798/j.issn.1009-153X.2015.12.020]
[4]齐向前　许　政　陈怀瑞　吕立权　白如林　侯立军　卢亦成　黄承光.硬脊膜动静脉瘘栓塞后Foix-Alajouanine综合征2例分析[J].中国临床神经外科杂志,2015,(04):233.[doi:10.13798/j.issn.1009-153X.2015.04.014]
[5]秦　杰　杨　铭　潘　力　蔡明俊　刘　鹏　杨　柳　安学峰　马廉亭.最大密度投影、双容积及双容积动态成像对硬脊膜动静脉瘘诊治的研究[J].中国临床神经外科杂志,2015,(05):257.[doi:10.13798/j.issn.1009-153X.2015.05.001]
　QIN Jie,YANG Ming,PAN Li,et al.Application of maximum intensity projection, double volume imaging and dynamic double volume imaging to diagnosis and treatment of the spinal dural arteriovenous fistulas[J].,2015,(10):257.[doi:10.13798/j.issn.1009-153X.2015.05.001]
[6]丁　卫　徐　昊　张所军　张华楸　陈如东　于加省　牛洪泉　雷　霆.复合手术治疗髓内复杂动静脉畸形1例并文献复习[J].中国临床神经外科杂志,2016,(09):553.[doi:10.13798/j.issn.1009-153X.2016.09.013]
[7]蔡明俊　马廉亭　杨　铭　潘　力.硬脊膜动静脉瘘的治疗分析[J].中国临床神经外科杂志,2018,(06):392.[doi:10.13798/j.issn.1009-153X.2018.06.003]
　CAI Ming-jun,MA Lian-ting,YANG Ming,et al.Clinical analysis of the diagnosis and treatment of spinal dural arteriovenous fistulae[J].,2018,(10):392.[doi:10.13798/j.issn.1009-153X.2018.06.003]
[8]张施远　蒋永明　曾　春　石海平.复合手术在脑动静脉畸形治疗中的应用[J].中国临床神经外科杂志,2018,(12):779.[doi:10.13798/j.issn.1009-153X.2018.12.004]
　ZHANG Shi-yuan,JIANG Yong-ming,ZENG Chun,et al.Hybrid surgery for cerebral arteriovenous malformations (report of 24 cases)[J].,2018,(10):779.[doi:10.13798/j.issn.1009-153X.2018.12.004]
[9]马廉亭　吴　涛　谢天浩　徐召溪.脊髓动静脉畸形、硬脊膜动静脉瘘、硬脊膜外动静脉瘘与脊髓周围动静脉瘘的鉴别[J].中国临床神经外科杂志,2019,(05):257.[doi:10.13798/j.issn.1009-153X.2019.05.001]
[10]王声播　孙蔚宇　张继波　武融青　辛　灿　陈劲草.神经外科复合手术后感染分析及防范措施[J].中国临床神经外科杂志,2019,(11):656.[doi:10.13798/j.issn.1009-153X.2019.11.006]
　WANG Sheng-bo,SUN Wei-yu,ZHANG Ji-bo,et al.Analysis of factors related to postoperative infection in neurosurgical patients undergoing craniotomy in hybridization operating room[J].,2019,(10):656.[doi:10.13798/j.issn.1009-153X.2019.11.006]
[11]李欢欢　宋雪倩　陈迎春　李　俊　盛柳青　别毕洲　汪志忠　马廉亭.复合手术治疗硬脊膜外动静脉瘘合并硬脊膜动静脉瘘1例 并文献复习[J].中国临床神经外科杂志,2020,(10):667.[doi:10.13798/j.issn.1009-153X.2020.10.003]
　LI Huan-huan,SONG Xue-qian,CHEN Ying-chun,et al.Hybrid operation for spinal epidural arteriovenous fistula: report of one cese and literature review[J].,2020,(10):667.[doi:10.13798/j.issn.1009-153X.2020.10.003]
[12]侯海东,罗国强,赵军,等.应用复合手术平台治疗硬脊膜动静脉瘘[J].中国临床神经外科杂志,2022,27(01):19.[doi:10.13798/j.issn.1009-153X.2022.01.007]
　HOU Hai-dong,LUO Guo-qiang,ZHAO Jun,et al.Clinical efficacy of hybrid operation for patients with spinal dural arteriovenous fistula[J].,2022,27(10):19.[doi:10.13798/j.issn.1009-153X.2022.01.007]

备注/Memo

备注/Memo:
2020-05-16收稿，2020-08-10修回
基金项目：国家自然科学基金（81601583）
通讯作者：李天晓，E-mail：dr.litianxiao@vip.163.com
更新日期/Last Update: 2020-10-20