【作者】 张李涛；

【导师】 陈高；

【作者基本信息】 浙江大学 ， 外科学， 2010， 硕士

【摘要】 目的：探讨血管内栓塞治疗脑动静脉畸形(AVM)栓塞率的影响因素,初步评价血管内栓塞治疗脑动静脉畸形的临床疗效。方法：回顾性分析我科2007.3～2010.3三年内在就诊期间进行血管内栓塞治疗的脑动静脉畸形患者共24例,比较分析Spetzler&Matin级别、栓塞材料、AVM供血方式等因素对AVM栓塞率的影响。结果：24例病例根据Spetzler&Martin分级,6例为Ⅰ级,12例为Ⅱ级,5例为Ⅲ级,1例为Ⅳ。Ⅰ级AVM患者平均栓塞率(93.0±8.2%)与Ⅱ～Ⅲ级(Ⅱ级73.0±17.1%,Ⅲ级77.0±15.2%)相比有显著性差异。Glubran-2胶的平均栓塞率为83.0±16%,Onyx-18胶的平均栓塞率为78.0±21.4%,真丝线段组为60.0±21.6%,两种胶水的栓塞效果明显优于真丝线段,而两种胶水的栓塞效果相比无显著性差异。单支供血动脉的AVM栓塞率(83.0±15.0%)明显好于多支供血动脉(66.0±23.0%),两组比较有显著性差异；小型AVM栓塞率(90.0±10.6%)与中型或大型AVM的栓塞率(中型68.0±15.0%,大型63.0±25.3%)相比亦有显著性差异。结论：Glubran-2胶与Onyx-18胶是AVM血管内栓塞治疗的理想栓塞材料。对单支动脉供血、分级为Ⅰ级、小型AVM血管内栓塞治疗有较好的疗效。更多还原

【Abstract】 Objective:This study was undertaken to analyze the influencing factors for the rate of embolization in the endovascular treatment of AVM, and to evaluate the therapeutic effect of endovascular embolization treatment.Methods:24 cases with anteriovenous malformations which underwent endovascular embolization treatment from March 2007 to March 2010 was studied. A statistical analyse was done to look for relationship between some influencing factors,such as Spetzler&Matin grade,embolization material,ize, feeding arteries, and the rate of embolization in the endovascular treatment of AVM.Results:24 patients with AVM were underwent endovascular treatment in our department(six Spetzler&Martin grade I, twelve grade II, five grade III and one grade IV). There is a significant difference of the mean rate of embolization betwee Spetzler&Matin grade I and grade II～III.The mean rate of embolization with Glubran-2 glue is 83.0±16%,while 78.0±21.4%with Onyx-18 glue.The group which received embolizalion with silk thread has a low rate of embolization(60.0±21.6%). The rate of embolization with Glubran-2 glue or Onyx-18 are higher than with silk thread. Compared with Glubran-2 glue, Onyx-18 doesn’t show statistical difference in the rate of embolization. The rate of embolization of AVM with single supplying arterie is 83.0±15.0%.The rate of embolization is significantly decreased when AVM has complex feeding arteries. There is a significant difference of the mean rate of embolization betwee AVM with different sizes.And small AVM with fewer feeding arteries is more likely to be embolized completely.Conclusion:Both Glubran-2 glue and Onyx-18 glue are optimal embolization material in the endovascular treatment of AVM. Endovascular embolization treatment has a more ideal therapeutic effcet to AVM which is single feeding arteries, Spetzler&Matin grade I,small sized.更多还原