[1]谢兵,丁明祥,刘天助,等.丙泊酚Wada试验在脑功能区动静脉畸形栓塞中的应用[J].中国临床神经外科杂志,2017,(02):74-76.[doi:10.13798/j.issn.1009-153X.2017.02.004]
　XIE Bing,DING Ming-xiang,LIU Tain-zhu,et al.Value of super-selective Wada testing with propofol in embolization of cerebral arteriovenous malformations in functional regions of the cerebral cortex[J].,2017,(02):74-76.[doi:10.13798/j.issn.1009-153X.2017.02.004]
点击复制

丙泊酚Wada试验在脑功能区动静脉畸形栓塞中的应用()
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02期
页码:
74-76
栏目:
论著
出版日期:
2017-02-20

文章信息/Info

Title:
Value of super-selective Wada testing with propofol in embolization of cerebral arteriovenous malformations in functional regions of the cerebral cortex
文章编号:
1009-153X（2017）02-0074-03
作者:
谢兵; 丁明祥; 刘天助; 韩志安; 唐晓琴
作者单位：528400 广东，中山市人民医院脑血管介入科（谢　兵、丁明祥、刘天助、韩志安、唐晓琴）
Author(s):
XIE Bing;  DING Ming-xiang;  LIU Tain-zhu;  HAN Zhi-an;  TANG Xiao-qin.
Department of Intervenient Treatment of Cerebrovascular Disease, Zhongshan Municipal People’s Hospital, Zhongshan 528400, China
关键词:
脑动静脉畸形; 功能区; Wada试验; 栓塞治疗
Keywords:
Cerebral arteriovenous malformation;  Wada testing;  Embolization;  Complication
分类号:
R 743.4; R 815.2
DOI:
10.13798/j.issn.1009-153X.2017.02.004
文献标志码:
A
摘要:
目的 探讨超选Wada试验在脑功能区动静脉畸形栓塞中的应用效果。方法 回顾性分析2013年5月至2016年5月收治的36例脑功能区动静脉畸形的临床资料，术前进行超选造影并用丙泊酚在超选的动脉完成Wada试验，再选择Onyx胶栓塞畸形血管团。结果 Wada试验中，3例出现抽搐、颤抖或不随意运动而放弃栓塞，7例出现运动障碍、4例语言障碍、2例记忆障碍而放弃栓塞治疗；其余20例共栓塞24次，每例栓塞l~3次，平均1.2次，完全栓塞8例。栓塞的20例中，发生缺血性并发症1例，无出血性并发症；术后随访2~23个月，无死亡病例，轻度神经功能障碍1例。结论 动脉超选行Wada试验进后，行脑功能区动静脉畸形的栓塞，可减少术后并发症的发生率。
Abstract:
Objective To investigate the effect of the super-selective Wada testing with propofol on the embolization of niduese in functional regions of the cerebral cortex in the patients with cerebral arteriovenous malformations (AVM). Method The clinical data of 36 patients with cerebral AVM in the functional regions hospitalized from May, 2013 to May, 2016 were analyzed retrospectively. The Wada testing with propofol was performed during the super-selective cerebral artery angiography in all the patients, and then the niduese were embolized with Onyx glue according to the results of the Wada testing. Results Of 36 patients with cerebral AVM, 20 received endovascular embolization and 16 did not due to the adverse reactions to Wada testing including convulsions and movement and language disorders. The niduese were completely embolized in 8 patients and incompletely in 12 patients. Of the 20 patients with embolization by Onyx glue, 1 had ischemic stroke, 1 mild neurological dysfunction and 18 were recovered well during the following-up from 2 to 23 months after the embolization. Conclusion The super-selective Wada testing may be helpful to reducing the incidence of post-embolization complications in the patients with cerebral AVM in the functional regions.

参考文献/References:

[1] Friedlander RM. Clinical practice: arteriovenous malforma- tions of the brain [J]. N Engl J Med, 2007, 356(26): 2704- 2712.
[2] 温玉东，魏建军. Onyx在脑动静脉畸形中应用进展[J]. 介 人放射学杂志，2010，19（11）：92l-924.
[3] Hauck EF, Welch BG, White JA, et al. Preoperative embo- lization of cerebral alteriovenous malformations with onyx [J]. Am J Neuroradiol, 2009, 30(3): 492-495.
[4] Mounayer C, Hammami N, Piotin M, et al. Nidal emboliza- tion of brain arteriovenous malformations using Onyx in 94 patients [J]. Am J Neuroradiol, 2007, 28(3): 518-523.
[5] Panagiotopoulos V, Gizewski E, Asgari S, et al. Embolization of intracranial arteriovenous malfommations with ethylene- vinyl alcohol copolymer (Onyx) [J]. Am J Neuroradiol, 2009, 30(1): 99-106.
[6] Ledezma CJ, Hoh BL, Carter BS, et al. Complications of cerebral arteriovenous malformation embolization: multiva- riate analysis of predictive factors [J]. Neurosurgery, 2006, 58(4): 602-611.
[7] 栾立明，葛明旭，薛　艳，等. 应用Onyx栓塞脑动静脉畸 形44例临床分析[J]. 医学影像杂志，2007，17（7）：667- 670.
[8] Maimont S，Strauss I, Frolov V, et al. Brain arteriovenous malformation treatment using a combination of Onyx and a new detachable tip microcatheter. SONIC: short-term results [J]. Am J Neuroradiol, 2010, 31(5): 947-954.
[9] Blackburn SL, Ashley WW Jr, Rich KM, et al. Combined endovascular embolization and stereotactic radiosurgery in the treatment of large arteriovenous malformations [J]. J Neurosurg, 201l, 114(6): 1758-1767.
[10] 吴红星，白　晋，刘　杰，等. Onyx栓塞治疗脑动静脉畸 形出血性并发症的初步分析[J]. 中华神经外科杂志， 2012，28（3）：264-267.
[11] 徐建林，周　兵，陈书达，等. 脑动静脉畸形介入栓塞后并 发症发生的相关危险因素分析[J]. 浙江医学，2010，32 （4）：454-456.
[12] Mikuni N, Takayama M, Satow T, et al. Evaluation of adverse effects in intracarotid propofol injection for Wada test [J]. Neurology, 2005, 65(11): 1813-1816.

相似文献/References:

[1]吴　亮　黄　玮　余永佳　利文倩　陆　健　林正锋.儿童低级别脑动静脉畸形的治疗[J].中国临床神经外科杂志,2016,(05):294.[doi:10.13798/j.issn.1009-153X.2016.05.012]
[2]罗　勇　艾文兵　孙　欢.妊娠期脑动静脉畸形的处理[J].中国临床神经外科杂志,2016,(07):439.[doi:10.13798/j.issn.1009-153X.2016.07.018]
[3]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,(02):196.[doi:10.13798/j.issn.1009-153X.2016.04.002]
[4]邱修辉　李光标　陈光忠.Glubran Ⅱ胶在脑动静脉畸形栓塞治疗中的应用[J].中国临床神经外科杂志,2016,(03):173.[doi:10.13798/j.issn.1009-153X.2016.03.015]
[5]孙荣辉　徐国政　杜　浩　宋　健　黄　河　赵曰圆　马廉亭.MRI与DSA影像融合联合电生理监测对脑动静脉畸形伴癫痫手术的价值[J].中国临床神经外科杂志,2015,(07):403.[doi:10.13798/j.issn.1009-153X.2015.07.007]
　SUN Rong-hui,XU Guo-zheng,DU Hao,et al.Value of MRI and 3D-DSA images fusion combined with intraoperative neuro-electrophysiological technique to surgery for intracranial arteriovenous malformation associated with epilepsy[J].,2015,(02):403.[doi:10.13798/j.issn.1009-153X.2015.07.007]
[6]罗　超　方友林.脑动静脉畸形的血管内治疗[J].中国临床神经外科杂志,2016,(10):630.[doi:10.13798/j.issn.1009-153X.2016.10.023]
[7]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.[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,(02):1.[doi:10.13798/j.issn.1009-153X.2017.01.001]
[8]刘　炎　杭春华.脑胶质瘤卒中误诊为脑动静脉畸形并出血1例[J].中国临床神经外科杂志,2018,(06):448.[doi:10.13798/j.issn.1009-153X.2018.06.025]
[9]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,(02):779.[doi:10.13798/j.issn.1009-153X.2018.12.004]
[10]马廉亭,谢天浩,徐召溪.脑动静脉畸形、硬脑膜动静脉瘘与软脑膜动静脉瘘的鉴别[J].中国临床神经外科杂志,2019,(06):321.[doi:10.13798/j.issn.1009-153X.2019.06.001]

备注/Memo

备注/Memo:
基金项目：中山市科技计划项目（2014A1FC122）
更新日期/Last Update: 1900-01-01