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：

损伤控制理论; 脑动静脉畸形; 血管内治疗; 综合治疗

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【摘要】　目的　探讨损伤控制理论（damage control theory，DCT）在脑动静脉畸形（arteriovenous malformations，AVM）诊断与治疗中的应用意义，以及指导治疗脑AVM的可行性。　方法　依据DCT原则，对2007年3月-2009年3月脑AVM患者进行积极治疗，并分析其治疗结果。　结果　根据DCT原则制订脑AVM患者的治疗方案，控制脑AVM的危险因素，降低其疾病发展风险，患者治疗结果比较满意。　结论　应用DCT原则指导脑AVM患者急性期处理及介入等治疗措施，可以提高患者的生存率，有效控制疾病的危险因素，提高治疗总有效率，具有临床指导意义。
【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.	赵继宗, 王硕, 隋大立, 等. 2086例脑动静脉畸形临床特征和手术治疗结果分析[J]. 中华神经外科杂志, 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, 吴中学, 姜鹏, 等. 非粘附性液体栓塞剂Onyx栓塞脑动静脉畸形[J]. 中华神经外科杂志, 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. 新型液态栓塞剂栓塞脑动静脉畸形70例经验总结[J]. 中华外科杂志, 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. 　赵继宗, 王硕, 隋大立, 等. 2086例脑动静脉畸形临床特征和手术治疗结果分析[J]. 中华神经外科杂志, 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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