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目的总结CT血管造影在诊治AVM破裂出血病例中的应用,探讨其临床价值。方法回顾性分析37例脑AVM破裂出血病例的术前检查,术中情况及术后随访结果。所有患者急诊行CT血管造影检查,并接受据其CT血管造影影像资料拟定急诊手术。结果 37例患者中一期手术切除35例,术后复查造影显示全切除者26例。术后三个月日常生活能力ADL评分:Ⅰ级20例,Ⅱ级8例,Ⅲ级5例,Ⅳ级2例,Ⅴ级2例。结论 CT血管造影检查快速敏感,能提高AVM破裂出血急诊检出率及一期全切率,从而改善AVM破裂出血患者的预后;CT血管造影或可替代DSA应用于AVM破裂出血急诊诊断与手术计划制定。
Objective To summarize the application of CT angiography in the diagnosis and treatment of AVM rupture hemorrhage and explore its clinical value. Methods Retrospective analysis of 37 cases of AVM rupture hemorrhage cases before surgery, intraoperative and postoperative follow-up results. All patients underwent emergency CT angiography, and according to their CT angiography data to develop emergency surgery. Results Of the 37 patients, 35 cases underwent surgical resection in one phase, and postoperative recanalization revealed 26 cases of total resection. ADL scores of daily living ability in three months after operation were 20 cases of grade Ⅰ, 8 cases of grade Ⅱ, 5 cases of grade Ⅲ, 2 cases of grade Ⅳ and 2 cases of grade Ⅴ. Conclusions CT angiography is fast and sensitive, which can improve the detection rate of acute rupture of AVM and the first-stage total resection rate so as to improve the prognosis of patients with ruptured AVM. CT angiography or DSA can be used in the emergency diagnosis and surgical planning of AVM rupture hemorrhage Make.