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本文分析了伽玛刀治疗61例脑血管畸形患者(AVM41例,AOVM20例),经6个月、2年随访,结果16个月以内血管巢闭塞占54%,18~24个月闭塞占80%;癫痫消失56%(平均1.1年);术后有1例再出血死亡(占AVM2.4%)。作者探讨了影响畸形消失的有关因素,认为在允许范围内,剂量大,病灶消失速度快;病灶容积小,消失速度快;儿童病灶消失快。癫痫控制率偏低,若结合PET综合定位和处理,可望提高癫痫治愈率。对位于重要功能区或容积过大脑血管畸形,可先予其他处理,残余部分再行伽玛刀治疗。
This article analyzes the gamma knife treatment of 61 patients with cerebrovascular malformations (AVM41 cases, AOVM20 cases), after 6 months, 2 years of follow-up, the results within 16 months of vascular nest occlusion accounted for 54%, 18 to 24 months of occlusion accounted for 80 %; Epilepsy disappeared 56% (average 1.1 years); postoperative bleeding re-bleeding (AVM2.4%). The author explores the factors that affect the disappearance of deformity, that within the allowable range, the dose is large, the lesions disappear faster; lesion volume is small, disappear faster; children disappeared faster lesions. Epilepsy control rate is low, combined with PET comprehensive positioning and treatment, is expected to improve the cure rate of epilepsy. Right in the important functional area or volume of cerebral vascular malformations, may be the other to deal with the remaining part of the gamma knife treatment.