Application of Damage Control Theory in the Treatment of Cerebral Arteriovenous Malformations_West China Medical Journal

Authors：

ZHANG Jianyong ¹ ,  ZHANG Ronglin ^1,2 , LIU Baohua ¹ , MU Shiqing ³ , YUAN Pu ¹ , GAO Mingming ¹

1. Department of Neurosurgery, Suqian People’s Hospital, Drum Tower Hospital Group of Nanjing, Suqian, Jiangsu 223800, P.R. China; 2. Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210009, P.R. China; 3. Department of Interventional Neuroradiology, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, P.R. China;

Corresponding?author：

ZHANG Ronglin, Email: carelifefirst@sina.com.cn

Keywords：

損傷控制理論; 腦動靜脈畸形; 血管內治療; 綜合治療

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【摘要】　目的　探討損傷控制理論（damage control theory，DCT）在腦動靜脈畸形（arteriovenous malformations，AVM）診斷與治療中的應用意義，以及指導治療腦AVM的可行性。　方法　依據DCT原則，對2007年3月-2009年3月腦AVM患者進行積極治療，并分析其治療結果。　結果　根據DCT原則制訂腦AVM患者的治療方案，控制腦AVM的危險因素，降低其疾病發展風險，患者治療結果比較滿意。　結論　應用DCT原則指導腦AVM患者急性期處理及介入等治療措施，可以提高患者的生存率，有效控制疾病的危險因素，提高治療總有效率，具有臨床指導意義。
【Abstract】　Objective　 To investigate the significance and feasibility of damage control theory (DCT) in diagnosing and treating cerebral arteriovenous malformations (AVM).　Methods　 According to the disease treatment principle of DCT, 76 patients with AVM diagnosed in our hospital from March 2007 to March 2009 were treated actively, and the treatment results were analyzed.　Results　 The risk factors of AVM was controlled, the development risk of AVM slowed down, and the therapeutic effect was satisfactory.　Conclusion　 According to the DCT principle, we could improve the survival rate of the patients, control the risk factors effectively, and improve the prognosis of the disease. DCT principle is clinically significant to guide the treatment of AVM.

Citation： ZHANG Jianyong,ZHANG Ronglin,LIU Baohua,MU Shiqing,YUAN Pu,GAO Mingming. Application of Damage Control Theory in the Treatment of Cerebral Arteriovenous Malformations. West China Medical Journal, 2011, 26(1): 54-56. doi: Copy

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13.	趙繼宗, 王碩, 隋大立, 等. 2086例腦動靜脈畸形臨床特征和手術治療結果分析[J]. 中華神經外科雜志, 2004, 20(2): 113-117.
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1. 　Johnson JW, Gracias VH, Schwab CW, et al. Evolution in damage control for exsanguinating penetrating abdominal injury[J]. J Trauma, 2001, 51(2): 261-269.
2. 　Penninga L, Penninga EI, Svendsen LB. Damage control Surgery in multiply traumatised patients[J]. Ugeskr Laeger, 2005, 167(36): 3403-3407.
3. 　Martin A, Schreiber. Damage control surgery[J]. Crit Care Clin, 2004, 20(1): 101-118.
4. 　Kouraklis G, Spirakos S, Glinavou A. Damage control surgery: an alternative approach for the management of critically injured patients[J]. Surg Today, 2002, 32(3): 195-202.
5. 　Batjer HH, Loftus CM. Textbook of neurological surgery. Principles and practice[M]. Philadelphia: Lippincott Williams and Wilkins, 2003: 2543-2569.
6. 　Robert M, Fridlalander MD. Arteriovenous malformations of the brain[J]. N Engl J Med, 2007, 356(26): 2704-2712.
7. 　Weber W, Kis B. Siekmann R. et al. Endovascular treatment of intracranial arteriovenous malformations with onyx: technical aspects[J]. AJNR Am J Neuroradiol, 2007, 28(2): 371-377.
8. 　李佑祥, 吳中學, 姜鵬, 等. 非粘附性液體栓塞劑Onyx栓塞腦動靜脈畸形[J]. 中華神經外科雜志, 2006, 22(3): 135-137.
9. 　Norbash AM, Marks MP, Lane B. Correlation of pressure measurements with angiographic characteristics predisposing to hemorrhage and steal in cerebral arteriovenous malformations[J]. AJNR Am J Neuroradiol, 1994, 15(5): 809-813.
10. 　Stapf C, Mohr JP, Pile-Spellman J, et al. Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation[J]. J Neurol Neurosurg Psychiatry, 2002, 73(3): 294-298.
11. 　宋冬雷, 冷冰, 徐斌, 等. 新型液態栓塞劑栓塞腦動靜脈畸形70例經驗總結[J]. 中華外科雜志, 2007, 4(45): 223-225.
12. 　Jafar JJ, David AJ, Berenstein A, et al. The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations[J]. J Neurosurg, 1993, 78(1): 60-69.
13. 　趙繼宗, 王碩, 隋大立, 等. 2086例腦動靜脈畸形臨床特征和手術治療結果分析[J]. 中華神經外科雜志, 2004, 20(2): 113-117.
14. 　Massager N, Régis J, Kondziolka D, et al. Gamma knife radiosurgery for brainstem arteriovenous malformations: preliminary results [J]. J Neurosurg, 2000, 93(Suppl 3): 102-103.

West China Medical Journal

Application of Damage Control Theory in the Treatment of Cerebral Arteriovenous Malformations

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