颅内硬脑膜动静脉瘘临床特点与预后分析

An analysis of the clinical characteristics and prognosis of intracranial dural arteriovenous fistula

摘要:

目的 分析颅内硬脑膜动静脉瘘的临床特征并探讨其预后的相关因素。方法 纳入南昌大学第一附属医院神经外科2012年3月—2019年9月期间收治48例硬脑膜动静脉瘘（DAVF）患者。以性别、年龄、供血动脉数、皮质静脉引流、瘘口位置、治疗方式及颅内出血作为亚变量进行回顾性分析。在患者出院6个月后，通过门诊及电话，对其进行随访。最后，对收集的数据进行Logistic回归分析。结果 脑膜中动脉是DAVF最多见的供血动脉（37.5%）。DAVF患者的首发症状以头痛为主（43.64%）。经血管内介入治疗的DAVF患者较经手术切除的患者预后好3.955倍；无颅内出血患者较伴有颅内出血患者的预后好4.464（1/0.224）倍。结论 对于硬脑膜动静脉瘘患者，尽早明确诊断，首选血管内治疗。

Abstract:

Objective To analyze the clinical characteristics of intracranial dural arteriovenous fistula (DAVF), and to investigate its prognostic factors. Methods Forty-eight patients with DAVF who were admitted to the Neurosurgery Department of the First Affiliated Hospital of Nanchang University from March 2012 to September 2019 were enrolled in the study. A retrospective analysis was performed, with sex, age, number of feeding arteries, cortical venous drainage, fistula location, treatment method, and intracranial hemorrhage as subvariables. The patients were followed up through outpatient visits and telephone interviews at 6 months after discharge. Finally, univariate and multivariate logistic regression analyses were performed on the collected data. Results The middle meningeal artery was the most common feeding artery for DAVF (37.5%). Headache was the primary symptom initially observed in patients with DAVF (43.64%). Patients with DAVF treated by endovascular treatment had a prognosis 3.955 times better than those treated by surgical resection; patients without intracranial hemorrhage had a prognosis 4.464 (1/0.224) times better than those with intracranial hemorrhage. Conclusions Patients with DAVF should be given a confirmed diagnosis as early as possible, and endovascular treatment is the preferred choice.