EDAS联合颅骨多点钻孔术治疗缺血性儿童烟雾病  

Encephalo-duro-arterlosynangiosis combined with multiple burr-hole operation in the treatment of ischemic pediatric Moyamoya disease

作　　者：张伟[1] 孙剑[2] 张东 宋春旺[1] 聂建刚[1] 张树民 

机构地区：[1]石家庄市第一医院神经外科,河北石家庄050011 [2]武警总医院神经血管外科,北京100039 [3]北京天坛医院脑血管病中心,北京100050 [4]元氏县中医院外科,河北元氏051130

出　　处：《中华神经外科疾病研究杂志》2013年第2期163-166,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(30772230)

摘　　要：目的探讨硬脑膜-动脉血管融通术(EDAS)联合颅骨多点钻孔术治疗缺血型儿童烟雾病(Moyamoya病)的临床疗效。方法选取近2年手术的缺血型烟雾病患儿42例,分为脑-硬膜-动脉血管融通术(EDAS)组和EDAS联合颅骨多点钻孔术联合组,对术后临床症状改善情况进行比较。结果单纯EDAS组19例,EDAS联合颅骨多点钻孔术组23例;随访6～17个月发现全部手术患者69.05%症状改善,EDAS组改善率52.63%,EDAS联合颅骨多点钻孔术组改善率82.61%,联合手术组较单纯EDAS组效果更好,具有统计学意义,P<0.05。结论 EDAS联合颅骨多点钻孔术联合应用操作简单,与单纯行EDAS相比,不增加围手术期并发症,有利于改善缺血型烟雾病患儿临床症状。Objective To evaluate the role of encephalo-duro-arterlosyuangiosis combined with multiple burrhole operation in the treament of pediatric ischemic Moyan^ya disease. Methods A total of 42 patients of ischemic pediatric Moyamoya disease admitted to the hospital over past 2 years were divided into two groups, the encephaloduro-arterlosynangiosis group （EDAS） and EDAS combined with multiple burr-hole operation group （EDAS ＋ MB）. The improvement of symptoms after operation was compared between two groups. Results EDAS was performed in 19 patients, while EDAS ＋MB in 23 of all 42 patients. Among all the patients during 6 -17 months＇follow-up, 69.05% got symptom improvement, with 52.63% in El）AS group and 82.61% in EDAS ＋ MB group, respectively. The EDAS ＋ MB group had better prognosis than El）AS group with statistical significance （P 〈0. 05）. Conclusion El）AS ＋ MB is beneficial to improve the clinical prognosis of the pediatric ischemic Moyamoya disease without the increase of complications.

关 键 词：儿童烟雾病 脑-硬膜-动脉血管融通术 颅骨多点钻孔术 EDAS联合颅骨多点钻孔术 

分 类 号：R726.5[医药卫生—儿科]