应用颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病  

Multiple burr hole surgery in conjunction with dural inversion and periosteum stitching for treatment of moyamoya disease

作　　者：郑德伟[1] 王志刚[1] 赵旭[1] 李卫国[1] 王益华[1] 孟庆虎[1] 曲春城[1] 王成伟[1] 

机构地区：[1]山东大学第二医院神经外科,济南250033

出　　处：《山东大学学报（医学版）》2011年第8期140-143,152,共5页Journal of Shandong University:Health Sciences

基　　金：山东省科技攻关项目(2007GG20002037)

摘　　要：目的探讨颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病的临床疗效。方法19例烟雾病患者以缺血首发17例，出血首发2例，均行颅骨多处钻孔硬膜翻转并骨膜贴敷术，术后随访2—48个月，随访数据进行统计学分析。结果缺血型患者中TIA患者术后TIA未再发作，脑梗塞患者术后原有缺血症状改善或消失。2例出血型患者术后随访至今未发生再出血。10例患者术后行DSA复查，45个骨孔均有新生血管向颅内生长，新生血管来自脑膜中动脉和颞浅动脉。1例伴发动脉瘤患者术后DSA复查动脉瘤未显影。结论颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病简便、安全、有效。Objective To evaluate the therapeutic effectiveness of multiple burr hole surgery in conjunction with dural inversion and periosteum stitching in the treatment of moyamoya disease. Method This procedure was performed on 19 patients with moyamoya disease： 17 cases of the ischemic-type and 2 of the hemorrhagic-type. Follow-up time was 2 to 48 months, and data were statistically analyzed. Result After surgery, the original TIA symptoms did not come back. For ischemic-type patients, the ischemic symptoms were relieved and for hemorrhagic-type patients, no re-bleed- ing symptoms were found. Revascularization originating from the middle meningeal artery and the superficial temporal artery was observed in all the 45 cranial holes in 10 cases examined, as shown using DSA. The aneurysm in one case disappeared. Conclusion The multiple burr hole surgery in conjunction with dural inversion and periosteum stitching is a simple, safe and effective procedure for the treatment of moyamoya disease.

关 键 词：烟雾病 脑血运重建术 颅骨钻孔 硬膜翻转 

分 类 号：R651.1[医药卫生—外科学]