颞浅动脉-大脑中动脉的直接搭桥术治疗低龄(5~11岁)儿童烟雾病11例  

Superficial temporal artery-middle cerebral artery direct bypass surgery in prepubertal children with moyamoya disease

作　　者：孙宁[1,2] 赵岩[1] 杨新宇[1] Ning Sun;Yan Zhao;Xinyu Yang(Department of Neurosurgery,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Neurosurgery,Tianjin Children Hospital,Tianjin 300070,China)

机构地区：[1]天津医科大学总医院神经外科,300052 [2]天津市儿童医院神经外科,300070

出　　处：《中华脑血管病杂志（电子版）》2021年第4期242-246,共5页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

摘　　要：目的提高低龄(5~11岁)儿童烟雾病较为细小的颞浅动脉-大脑中动脉搭桥手术的成功率。方法回顾性分析2017年8月至2020年7月天津医科大学总医院收治的11例5~11岁烟雾病患儿。所有患儿均采用在显微镜下“直角修剪”颞浅动脉末端、扩大吻合口面积、间断缝合统一打结等技术操作方法完成细小的颞浅动脉-大脑中动脉搭桥手术。结果共完成了18侧直径<1 mm的颞浅动脉-大脑中动脉搭桥手术。所有患儿围手术期没有出现脑出血、短暂性脑缺血发作、脑梗死等并发症,7侧进行了数字减影血管造影复查,见吻合血管通畅,颞肌贴附处也有显著的供血。结论在改进的技术措施基础上,结合严格的操作训练,神经外科医师可以完成直径<1 mm的血管吻合,使烟雾病患儿受益。Objective In order to evaluate the effect of small superficial temporal artery-middle cerebral artery bypass surgery on children with moyamoya disease.Methods We used technical methods such as"right-angle trimming"of the superficial temporal artery end under a microscope,intermittent sutures and all together knotting,and expansion of the anastomotic area,under which the tiny superficial temporal artery-middle cerebral artery bypass surgery was completed for children aged from 5 to 11 years with moyamoya disease.Results A total of 11 cases of superficial temporal artery-middle cerebral artery bypass surgery with a diameter of less than 1 mm on 18 sides were completed in this group.During the perioperative period,there were no complications such as cerebral hemorrhage,transient ischemic attack(TIA),and cerebral infarction.Digital subtract angiography(DSA)was performed on 7 sides.It was found that the anastomotic vessels were unobstructed,and the temporal muscle attachment also had significant blood supply to the brain.Conclusion On the basis of improved technical measures,combined with strict operation training,neurosurgeons can complete vascular anastomoses with a diameter of less than 1 mm,which will benefit children with moyamoya disease.

关 键 词：儿童 烟雾病 颞浅动脉-大脑中动脉搭桥术 

分 类 号：R726.5[医药卫生—儿科]