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目的探讨显微外科治疗脑动静脉畸形临床特点、手术方法及显微手术技巧,提高疗效。方法对2005年6月至2011年6月我科收治的60例脑AVM采用显微外科手术治疗。按照Spetzler-Martin分级系统,Ⅰ级8例,Ⅱ级20例,Ⅲ级18例,Ⅳ级12例,V级2例。结果显微外科手术治疗60例,52例完全切除病灶,9例术前栓塞后手术切除,4例未完全切除者,术后行γ刀治疗。Glasgow评分(COS):恢复良好49例,中度残疾7例,严重残疾2例,死亡2例。结论显微手术切除脑AVM的最有效的治疗手段;对于大多数巨大的AVM栓塞、γ刀及显微手术联合治疗可取得良好的疗效。
Objective To investigate the clinical characteristics, surgical methods and microsurgical skills of microsurgical treatment of cerebral arteriovenous malformations to improve the curative effect. Methods From June 2005 to June 2011, 60 cases of brain AVM were treated by microsurgery in our department. According to the Spetzler-Martin classification system, there were 8 cases of grade Ⅰ, 20 cases of grade Ⅱ, 18 cases of grade Ⅲ, 12 cases of grade Ⅳ and 2 cases of grade V. Results Microsurgery was performed in 60 cases, complete resection in 52 cases, surgical resection in 9 cases before embolization, and in 4 cases with incomplete resection. Gamma knife treatment was performed after operation. Glasgow score (COS): 49 cases recovered well, 7 cases of moderate disability, 2 cases of severe disability and 2 cases of death. Conclusions Microsurgery is the most effective treatment for the resection of brain AVM. For most of the huge AVM embolization, γ knife and microsurgical treatment can achieve good results.