[1]武跃辉 单峤 李培栋 高东海 王新军.未破裂脑动静脉畸形伴癫痫患者血管内栓塞的疗效及临床预后[J].卒中与神经疾病杂志,2020,27(02):185-188.[doi:10.3969/j.issn.1007-0478.2020.02.009]
　Wu Yuehui,Dan Qiao,Li Peidong,et al.Clinical efficacy and prognosis of intravascular embolization in the treatment of patients with unruptured CVAM and epilepsy[J].Stroke and Nervous Diseases,2020,27(02):185-188.[doi:10.3969/j.issn.1007-0478.2020.02.009]
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未破裂脑动静脉畸形伴癫痫患者血管内栓塞的疗效及临床预后()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第27卷
期数:
2020年02期
页码:
185-188
栏目:
论 著
出版日期:
2020-03-15

文章信息/Info

Title:
Clinical efficacy and prognosis of intravascular embolization in the treatment of patients with unruptured CVAM and epilepsy
文章编号:
1007-0478(2020)02-0185-04
作者:
武跃辉 单峤 李培栋 高东海 王新军
450052 郑州大学第五附属医院神经外科二病区[武跃辉 单峤 李培栋 高东海 王新军(通信作者)]
Author(s):
Wu Yuehui;  Dan Qiao;  Li Peidong;  et al.
the Second Neurosurgery Ward, Department of Neurosurgery, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052
关键词:
脑动静脉畸形 癫痫 血管内栓塞 疗效 预后
Keywords:
CVAM Epilepsy Endovascular embolism Clinical effect Prognosis
分类号:
R743.4 R742.1
DOI:
10.3969/j.issn.1007-0478.2020.02.009
文献标志码:
A
摘要:
目的 探讨未破裂脑动静脉畸形(CAVM)伴癫痫患者血管内栓塞的疗效及临床预后。方法 回顾性分析本院2014年1月-2018年12月收治未破裂CVAM伴癫痫患者共104例的临床资料,均行血管内栓塞治疗,比较治疗前后NIHSS评分、mRS评分、头疼严重程度分级、Spetzler-Martin分级、Engel分级及QOLIE-31量表评分。结果 患者治疗后NIHSS评分和mRS评分显著低于治疗前(P<0.05)。患者治疗后头疼轻度比例显著高于治疗前(P<0.05); 患者治疗后头疼中度和重度比例均显著低于治疗前(P<0.05); 患者治疗后Spetzler-Martin分级和Engel分级I-II级比例显著高于治疗前(P<0.05); 患者治疗后Spetzler-Martin分级和Engel分级III-IV级比例显著低于治疗前(P<0.05)。患者治疗后情感、精力、发作担忧、综合健康状态及社会功能评分均显著高于治疗前(P<0.05); 治疗前后药物影响评分比较无显著性差异(P>0.05)。Spetzler-Martin分级低级别组患者平均QOLIE-31量表评分显著高于高级别组(P<0.05); 完全及次全栓塞组平均QOLIE-31量表评分显著高于部分栓塞组(P<0.05); Engel分级预后良好组平均QOLIE-31量表评分显著高于预后不良组(P<0.05)。结论 未破裂CVAM伴癫痫患者血管内栓塞可有效保护神经功能,控制病情进展,降低癫痫发作严重程度,并有助于改善生存质量; 患者生活质量改善与AVM形态结构、栓塞程度及癫痫发作控制效果密切相关
Abstract:
ObjectiveTo investigate the clinical efficacy and prognosis of intravascular embolization in the treatment of patients with unruptured CVAM and epilepsy.Methods Clinical data of 104 patients with unruptured CVAM and epilepsy were chosen from January 2014 to December 2018 in our hospital and endovascular embolization was performed in all patients. The NIHSS scores, mRS scores, severity grade of headache, Spetzler-Martin grade, Engel grade and QOLIE-31 scores of all patients were compared before and after treatment.Results The NIHSS scores and mRS scores after treatment of all patients were significantly less than those before treatment(P<0.05). The proportion of mild grade of headache after treatment of all patients were significantly higher than those before treatment(P<0.05). The proportion of middle and severe grade of headache after treatment of all patients were significantly lower than those before treatment(P<0.05). The proportion of I-II degree foe Spetzler-Martin grade and Engel grade after treatment of all patients were significantly higher than those before treatment(P<0.05). The proportion of III-IV degree foe Spetzler-Martin grade and Engel grade after treatment of all patients were significantly lower than those before treatment(P<0.05). The emotional, energetic, episodic anxiety, comprehensive health status and social function scores after treatment of all patients were significantly more than those before treatment(P<0.05). There was no significant difference in the drug impact score between before and after treatment(P>0.05).Conclusion Intravascular embolization in the treatment of patients with unruptured CVAM and epilepsy could efficiently protect the nervous function, control the disease progress, reduce the severity of epileptic seizures and be helpful to improve the quality of life

参考文献/References:

[1] 张印松,张海峰,董玉书,等.未破裂颅内动静脉畸形患者生命质量及其影响因素分析[J].中华神经外科杂志,2018,34(5):515-518.
[2] Abla AA,Rutledge WC,Seymour ZA,et al.A treatment paradigm for high-grade brain arteriovenous malformations: volume-staged radiosurgical downgrading followed by microsurgical resection[J].J Neurosurg,2015,122(2):419-432.
[3] Chen QY,Zhu XR,Zhang Y.The hemodynamic changes in patients with cerebral arteriovenous malformations before and after interventional embolization therapy with glubran 2 acrylic glue[J].Eur Neurol,2017,78(3/4):169-175.
[4] Huo XC,Jiang YH,Lv XL,et al.Gamma knife surgical treatment for partially embolized cerebral arteriovenous malformations[J].J Neurosurg,2016,124(3):767-776.
[5] 田新英,王丽琴,陈丽萍.脑血管疾病[M].北京:军事医学科学出版社,2015:321-322.
[6] 陈锋龙,王帆,龙建武,等.复合手术室介入栓塞联合显微外科与单纯显微外科治疗脑动静脉畸形出血的比较分析[J].国际神经病学神经外科学杂志,2018,45(1):18-21.
[7] 白卫星,贺迎坤,李天晓,等.颈内静脉入路血管内根治性栓塞治疗脑动静脉畸形的可行性研究[J].中华放射学杂志,2018,52(2):131-134.
[8] Endo T,Endo H,Sato K,et al.Surgical and endovascular treatment for spinal arteriovenous malformations[J].Neurol Med Chir(Tokyo),2016,56(8):457-464.
[9] Bostroem JP,Bruckermann R,Pintea B,et al.Treatment of cerebral arteriovenous malformations with radiosurgery or hypofractionated stereotactic radiotherapy in a consecutive pooled linear accelerator series[J].World Neurosurg,2016,94(3):328-338.
[10] Strauss I,Haim O,Umansky D,et al.Impact of onyx embolization on radiosurgical management of cerebral arteriovenous malformations: treatment and outcome[J].World Neurosurg,2017,108(4):656-661.
[11] Sun Y,Tian RF,Li AM,et al.Unruptured epileptogenic brain arteriovenous malformations[J].Turk Neurosurg,2016,26(3):341-346.
[12] Sveinsson OA,Olafsson IH,Valdimarsson EM.Cerebral arteriovenous malformations - overview[J].Laeknabladid,2016,102(9):385-390.
[13] Elkordy A,Endo H,Sato K,et al.Embolization of the choroidal artery in the treatment of cerebral arteriovenous malformations[J].J Neurosurg,2017,126(4):1114-1122.
[14] Mijnsbrugge WV,Laleman W,Van Steenbergen W,et al.Long-term clinical and radiological outcome of endovascular embolization of pancreatitis-related pseudoaneurysms[J].Acta radiol,2017,58(3):316-322.
[15] Mendes GA,Iosif C,Silveira EP,et al.Transvenous embolization in pediatric plexiform arteriovenous malformations[J].Neurosurgery,2016,78(3):458-465.
[16] Cossu G,Daniel RT,Messerer M.Cerebral abscess after neuro-vascular embolization: Own experience and review of the literature[J].Acta Neurochir(Wien),2017,159(3):583-591.

备注/Memo

备注/Memo:
(2019-07-19收稿)
更新日期/Last Update: 2020-03-15