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

Clinical effect and safety of interventional embolization combined with microsurgery in hybrid operating room versus microsurgery alone in treatment of hemorrhage from cerebral arteriovenous malformations

摘要:

目的 对比分析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的安全性与有效性。方法 回顾性收集复合手术室介入栓塞联合显微外科与单纯显微外科治疗出血脑动静脉畸形患者各10例，比较两组术前GCS评分、Spetzler&Martin分级，术中出血量、术后并发症记录，术后3个月mRS、GOS神经功能评分。结果 ①复合手术组能大部分完整AVM切除，避免二次手术；②复合手术室下介入栓塞联合显微外科较单纯显微外科治疗破裂出血的脑动静脉畸形，出血量明显减少，差异具有统计学意义（P<0.05）；③复合手术室下介入栓塞联合显微外科术后并发症，明显小于单纯显微外科治疗破裂出血的脑动静脉畸形，其差异具有统计学意义（P<0.05）。结论 在术中出血量、术后并发症及术后致残率方面，复合手术室介入栓塞联合显微外科明显优于单纯显微外科治疗出血脑动静脉畸形。

Abstract:

Objective To investigate the clinical effect and safety of interventional embolization combined with microsurgery in the hybrid operating room versus microsurgery alone in the treatment of hemorrhage from cerebral arteriovenous malformations (AVMs).Methods A retrospective analysis was performed on the clinical data of 10 patients who underwent interventional embolization combined with microsurgery in the hybrid operating room in the treatment of hemorrhage from AVMs, as well as 10 patients who underwent microsurgery alone for this disease. The two groups were compared in terms of preoperative Glasgow Coma Scale score and Spetzler and Martin grade, intraoperative blood loss, postoperative complications, and modified Rankin Scale and Glasgow Outcome Scale scores at 3 months after surgery.Results In the interventional embolization+microsurgery group, AVMs were resected completely in most cases, avoiding secondary surgery. Compared with the microsurgery group, the interventional embolization+microsurgery group had significantly less intraoperative blood loss and a significantly lower incidence of postoperative complications (both P<0.05).Conclusions For hemorrhage from AVMs, interventional embolization combined with microsurgery in the hybrid operating room is superior to microsurgery alone in terms of intraoperative blood loss, postoperative complications, and postoperative disability.