[1]唐　爽　蒋永明　龙　勇　曾　春.复合手术平台治疗脑动静脉畸形[J].中国临床神经外科杂志,2017,(01):1-3.[doi:10.13798/j.issn.1009-153X.2017.01.001]
　TANG Shuang,JIANG Yong-ming,LONG Yong,et al.R 743.4; R 651.1+2[J].,2017,(01):1-3.[doi:10.13798/j.issn.1009-153X.2017.01.001]
点击复制

复合手术平台治疗脑动静脉畸形()
分享到：

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

卷:
期数:
2017年01期
页码:
1-3
栏目:
论著
出版日期:
2017-01-18

文章信息/Info

Title:
R 743.4; R 651.1+2
文章编号:
1009-153X（2017）01-0001-03
作者:
唐　爽　蒋永明　龙　勇　曾　春
629000 四川，遂宁市中心医院神经中心
Author(s):
TANG Shuang;  JIANG Yong-ming;  LONG Yong;  ZENG Chun.
Department of Neurosurgery, Suining Central Hospital, Suining 629000, China
关键词:
脑动静脉畸形; 显微手术; 血管内栓塞; 复合手术室; 术中脑血管造影
Keywords:
Cerebral arteriovenous malformation;  Microneurosurgery;  Neurointervention;  Hybrid oprating room
分类号:
R 743.4; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2017.01.001
文献标志码:
A
摘要:
目的 探讨复合手术平台在治疗脑动静脉畸形（AVM）中的应用价值。方法 2014年3月至2015年5月收治脑AVM 21例，均在复合手术室完成手术治疗，其中5例根据术前评估仅接受开颅切除术及术中脑血管造影，16例接受栓塞加开颅切除术。结果 21例手术时间为3.2~7.8 h，平均（5.8±1.3） h。16例栓塞后畸形血管团体积缩小46.7%~64.6%。无手术死亡病例，未发生与造影相关并发症。术后发生偏瘫1例，失语1例；手术致残率为9.5%（2/21）。术后发生脑梗死（直径<2.5 cm）1例，无术后颅内出血、手术相关切口感染或颅内感染。18例术后随访6个月，发生迟发性癫痫1例；术后6个月复查DSA或CTA均证实畸形血管团完整切除；16例改良Rankin量表评分1分。结论 利用复合手术平台治疗脑AVM可明显增加手术全切率，并降低手术相关并发症。
Abstract:
Objective To summarize clinical experience in treating cerebral arteriovenous malformations (AVM) in hybrid operating room. Methods Twenty-one patients with cerebral AVM definitely diagnosed by CTA or DSA were treated in a hybrid operating room from March, 2014 to May, 2015. The arteries feeding blood to AVM were embolized by Onyx and then the niduses were resected by microsurgery under intraoperative DSA guidance in 16 patients. Other 5 patients received resection of the AVM niduses under the guidance of intraoperative DSA. Results The DSA after the surgery showed that AVM niduses were totally resected in all the patients. There was partial hemiplegia in 1 patient, aphasia in 1 and cerebral infarction (diameter <2.5 cm) in 1 after the surgery. No patients died from the surgery. Of 18 patients followed up for 6 months, 1 suffered from delayed epilepsy, and the AVM niduses disappeared completely in 16 patients receiving CTA or DSA examination during the following up. Conclusion The rate of total resection of cerebral AVM niduses can be increased and the rate of postoperative complication occurrence can be decreased in the patients with cerebral AVM when they are treated in the hybrid operating room.

参考文献/References:

[1] S?derman M, Andersson T, Karlsson B, et al. Management of patients with brain arteriovenous malformations [J]. Eur J Radiol, 2003, 46(3): 195-205.
[2] Dehdashti AR, Thines L, Da Costa LB, et al. Intraoperative biplanar rotational angiography during neurovascular sur- gery: technical note [J]. J Neurosurg, 2009, 111: 188-192.
[3] Murayama Y, Irie K, Saguchi T. Robotic digital subtraction angiography systems within the hybrid operating room [J]. Neurosurgery, 2011, 68(5): 1427-1432.
[4] Murayama Y, Saguchi T, Ishibashi T, et al. Endovascular operating suite: future directions for treating neurovascular disease [J]. J Neurosurg, 2006, 104: 925-930.
[5] Xu F, Zhong J, Ray A, et al. Stereotactic radiosurgery with and without embolization for intracranial arteriovenous malformations: a systematic review and meta-analysis [J]. Neurosurg Focus, 2014, 37(3): E16.
[6] Karlsson B, Lax I, S?derman M. Can the probability for obli- teration of arteriovenous malformations following radiosur- gery be accurately predicted [J]. Int J Radiat Oncol Biol Phys, 1999, 43(2): 313-319.
[7] 赵继宗，王　硕，隋大立，等. 2086 例脑动静脉畸形临床 特征和手术治疗结果分析[J]. 中华神经外科杂志，2004， 20：113-117.
[8] Potts MB, Lau D, Abla AA, et al. Current surgical results with low-grade brain arteriovenous malformations [J]. J Neurosurg, 2015, 122(4): 912-920.
[9] Munshi I, Macdonald RL, Weir BK. Intraoperative angio- graphy of brain arteriovenous malformations [J]. Neurosur- gery, 1999, 45: 491-499.
[10] Derdeyn CP, Moran CJ, Cross DT, et al. Intraoperative digi- tal subtraction angiography: a review of 112 consecutive examinations [J]. Am J Neuroradiol, 2005, 16: 307-318.
[11] Hoh BL, Carter BS, Ogilvy CS. Incidence of residual intra- cranial AVMs after surgical resection and efficacy of imme- diate surgical re-exploration [J]. Acta Neurochir (Wien), 2004, 146(1): 1-7.
[12] Schaller C, Schramm J, Haun D. Signi?cance of factors con- tributing to surgical complications and to late outcome after elective surgery of cerebral arteriovenous malformations [J]. J Neurol Neurosurg Psychiatry, 1998, 65(4): 547-554.
[13] Murayama Y, Arakawa H, Ishibashi T, et al. Combined sur- gical and endovascular treatment of complex cerebrovascu- lar diseases in the hybrid operating room [J]. J Neurointer- vent Surg, 2013, 5: 489-493.
[14] Kotowski M, Sarrafzadeh A, Schatlo B, et al. Intraoperative angiography reloaded: a new hybrid operating theater for combined endovascular and surgical treatment of cerebral arteriovenous malformations: a pilot study on 25 patients [J]. Acta Neurochir (Wien), 2013, 155: 2071-2078.
[15] Fandino J, Taussky P, Marbacher S, et al. The concept of a hybrid operating room: applications in cerebrovascular sur- gery [J]. Acta Neurochir Suppl, 2013, 115: 113-117.
[16] 袁　葛，赵继宗，王　硕，等. 术中血管造影在脑动静脉畸 形手术中的应用[J]. 北京大学学报医学版，2007，39： 412-415.
[17] 马驰原，史继新，王汉东，等. 吲哚菁绿血管造影在脑血管 畸形手术中的作用[J]. 中国脑血管病杂志，2008，5：369- 378.

相似文献/References:

[1]林国中　王振宇　马长城　赵　薇.神经电生理监测下显微手术切除脊髓髓内肿瘤[J].中国临床神经外科杂志,2015,(11):647.[doi:10.13798/j.issn.1009-153X.2015.11.003]
　LIN Guo-zhong,WANG Zhen-yu,MA Chang-cheng,et al.Clinical value of intraoperative electrophysiological monitoring to microsurgery for intramedullary spinal tumors[J].,2015,(01):647.[doi:10.13798/j.issn.1009-153X.2015.11.003]
[2]谢京城　王振宇　陈晓东.骶管终丝脊膜囊肿合并脊髓拴系综合征的诊断和治疗[J].中国临床神经外科杂志,2015,(11):651.[doi:10.13798/j.issn.1009-153X.2015.11.004]
　XIE Jing-cheng,WANG Zhen-yu,CHEN Xiao-dong.Diagnosis and surgical treatment of sacral spinal meningeal cysts of fila terminale complicated with tethered spinal cord syndrome[J].,2015,(01):651.[doi:10.13798/j.issn.1009-153X.2015.11.004]
[3]于　涛　黄正通　王振宇.椎管内脊膜囊肿的临床特征和治疗方法[J].中国临床神经外科杂志,2015,(11):654.[doi:10.13798/j.issn.1009-153X.2015.11.005]
　YU Tao,HUANG Zheng-tong,WANG Zhen-yu.Clinical features and treatment of intraspinal arachnoid cysts[J].,2015,(01):654.[doi:10.13798/j.issn.1009-153X.2015.11.005]
[4]谢宝树　王　宇　贾　锋　张　林　殷玉华.神经电生理监测下显微手术治疗成人脊髓栓系综合征[J].中国临床神经外科杂志,2015,(11):658.[doi:10.13798/j.issn.1009-153X.2015.11.006]
　XIE Bao-shu,WANG Yu,JIA Feng,et al.Intraoperative electrophysiological monitoring-guided microsurgery on tethered spinal cord syndrome in adults[J].,2015,(01):658.[doi:10.13798/j.issn.1009-153X.2015.11.006]
[5]赵东升　王正君　孙刚锋　费　舟　姬西团　李　娟　万晓强.椎管内畸胎瘤的诊断与治疗[J].中国临床神经外科杂志,2015,(11):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
　ZHAO Dong-sheng,WANG Zheng-jun,SUN Gang-feng,et al.Dignosis and treatment of intraspainal teratomas[J].,2015,(01):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
[6]陈晓东　于　涛　王振宇.脊髓髓内神经鞘瘤的诊断与治疗[J].中国临床神经外科杂志,2015,(11):670.[doi:10.13798/j.issn.1009-153X.2015.11.010]
　CHEN Xiao-dong,YU Tao,WANG Zhen-yu.Diagnosis and treatment of intramedullary spinal schwannomas[J].,2015,(01):670.[doi:10.13798/j.issn.1009-153X.2015.11.010]
[7]马　磊　张海红　张　威　衡立君　孙树凯　贾　栋.眶上锁孔入路手术切除前颅底脑膜瘤的临床效果[J].中国临床神经外科杂志,2015,(11):680.[doi:10.13798/j.issn.1009-153X.2015.11.013]
　MA Lei,ZHANG Hai-hong,ZHANG Wei,et al.Microsurgery through supraorbital keyhole approach for anterior cranial fossa meningiomas[J].,2015,(01):680.[doi:10.13798/j.issn.1009-153X.2015.11.013]
[8]李春坡　郑　军　李海元　边　涛　韩安国.侧脑室三角区小型脑膜瘤的显微外科治疗[J].中国临床神经外科杂志,2015,(11):694.[doi:10.13798/j.issn.1009-153X.2015.11.018]
[9]张兆斯　但　炜　王　刚　周　超　孙　超　谢延风　石全红　詹　彦.咪达唑仑和丙泊酚诱导麻醉对继发性癫痫术中皮层脑电图的影响[J].中国临床神经外科杂志,2016,(05):261.[doi:10.13798/j.issn.1009-153X.2016.05.002]
　ZHANG Zhao-si,DAN Wei,WANG Gang,et al.Effects of midazolam or propofol used for induction of anesthesia on intraoperative ECoG in patients with secondary epilepsy[J].,2016,(01):261.[doi:10.13798/j.issn.1009-153X.2016.05.002]
[10]赵　平　王雄伟　汪　雷　马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
　ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(01):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
[11]张海峰　梁国标　于春泳　王晓刚　李志清　高　旭　董玉书　郭学军.在复合手术室治疗脑动静脉畸形的初步探讨[J].中国临床神经外科杂志,2016,(04):196.[doi:10.13798/j.issn.1009-153X.2016.04.002]
　ZHANG Hai-feng,LIANG Guo-biao,YU Chun-yong,et al.A preliminary study of hybrid operation for cerebral arteriovenous malformations[J].,2016,(01):196.[doi:10.13798/j.issn.1009-153X.2016.04.002]
[12]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,(01):779.[doi:10.13798/j.issn.1009-153X.2018.12.004]
[13]陈其钻,王守森,刘峥,等.神经导航引导下手术切除左侧颞叶深部小型脑动静脉畸形1例[J].中国临床神经外科杂志,2023,28(01):62.[doi:10.13798/j.issn.1009-153X.2023.01.021]
[14]杨子舰,方伟,赵振伟,等.术中DSA辅助手术切除脑动静脉畸形的安全性及有效性[J].中国临床神经外科杂志,2023,28(03):150.[doi:10.13798/j.issn.1009-153X.2023.03.002]
　YANG Zi-jian,FANG Wei,ZHAO Zhen-wei,et al.Safety and efficacy of microsurgical resection assisted by intraoperative DSA for patients with cerebral arterio-venous malformations[J].,2023,28(01):150.[doi:10.13798/j.issn.1009-153X.2023.03.002]

备注/Memo

备注/Memo:
基金项目：四川省遂宁市科研项目
通讯作者：曾　春，E-mail：zch_217@163.com
更新日期/Last Update: 2016-10-28