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目的探讨脑动静脉畸形并发癫发作的相关危险因素以及癫的合理预防措施。方法回顾性分析286例脑动静脉畸形患者的临床及脑动静脉畸形基线资料。根据是否合并癫发作分为癫组和对照组。分析脑动静脉畸形患者并发癫发作的危险因素,观察癫组92例患者的发作类型及发作频率以及药物治疗反应情况。结果癫组与对照组畸形血管团的位置、畸形血管团直径、静脉引流方向等因素比较差异明显(P<0.05);非条件多因素Logistic回归分析显示对脑动静脉畸形患者癫发作有显著影响的因素为畸形团直径大于3 cm和由浅静脉或者浅深静脉共同引流(P<0.05)。经过抗癫药物治疗,癫组有69例患者癫发作得到了完全控制,余患者发作频率均有不同程度减低。结论畸形团直径大于3cm和由浅静脉或者浅深静脉共同引流是脑动静脉畸形患者并发癫的危险因素;脑动静脉畸形合并的癫发作是一个相对良性过程,抗癫药物对多数癫患者治疗有效。
Objective To investigate the risk factors of cerebral arteriovenous malformation complicated by epilepsy and the reasonable preventive measures of epilepsy. Methods The clinical and cerebral arteriovenous malformation baseline data of 286 patients with cerebral arteriovenous malformation were retrospectively analyzed. According to whether the merger of epileptic seizures were divided into epilepsy group and control group. To analyze the risk factors of paroxysmal epileptic seizures in patients with cerebral arteriovenous malformations and to find out the seizure type and frequency of seizures and drug treatment response in 92 epileptic patients. Results There were significant differences in the location of the abnormal vascular group, the diameter of the abnormal vascular group and the direction of venous drainage in the epileptic group and the control group (P <0.05). The unconditional multivariate Logistic regression analysis showed that there was significant difference in the incidence of epileptic seizures Significantly affected by the diameter of the deformity group is greater than 3 cm and by shallow vein or shallow deep vein drainage (P <0.05). After anti-epileptic drug treatment, epilepsy group 69 patients with epileptic seizures have been completely controlled, the rest of the patients seizure frequency decreased to varying degrees. Conclusions Deformity group is more than 3cm in diameter and co-drained by superficial or deep vein is a risk factor for patients with cerebral arteriovenous malformation complicated with epilepsy. Cerebral arteriovenous malformation combined with epileptic seizure is a relatively benign process. Antiepileptic drugs are effective for most epilepsy patient treatment effective.