烟雾病合并动脉瘤手术治疗临床疗效分析  

Clinical analysis of surgical treatment of moyamoya disease complicated with aneurysm

作　　者：韩守孟 田其[1] 蔡林志 张申起[1] 王龙[1] 陈谦学[1] 李明昌[1] HAN Shoumeng;TIAN Qi;CAI Linzhi(Department of Neurosurgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院神经外科,430060

出　　处：《临床外科杂志》2022年第3期248-251,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金面上项目(81971870,82172173)。

摘　　要：目的 探讨烟雾病合并颅内动脉瘤手术治疗的疗效。方法 2015年1月-2021年6月我院手术治疗的烟雾病病人264例,其中无动脉瘤组233例,为单纯烟雾病,行颅内外动脉搭桥治疗。合并动脉瘤组31例,为烟雾病合并颅内动脉瘤,行搭桥和颅内动脉瘤介入栓塞术或开颅夹闭术。术后行CT血管造影或数字减影血管造影随访,并记录mRS评分。结果 有完整随访资料237例,预后良好(mRS<3分)209例,其中无动脉瘤组191例(191/212,90.1%),合并动脉瘤组18例(18/25,72.0%),两组比较差异有统计学意义(P<0.05);Suzuki分期早期157例,其中无动脉瘤组144例(144/233,61.8%),合并动脉瘤组13例(13/31,41.9%),两组比较差异有统计学意义(P<0.05)。结论 烟雾病合并颅内动脉瘤,相对于单纯的烟雾病病人,其Suzuki分期较高,可能导致术后并发症发生率增加,预后较差。Objective To investigate the clinical effect of surgical treatment for moyamoya disease complicated with intracranial aneurysm.Methods A retrospective analysis was performed on 264 patients with moyamoya disease treated by surgery in Department of Neurosurgery, Renmin Hospital of Wuhan University from January 2015 to June 2021,including 233 patients in the non aneurysmal group(patients with moyamoya disease treated with intracranial and extracranial artery bypass) and 31 patients in the aneurysmal group(patients with moyamoya disease complicated with intracranial aneurysm underwent bypass and intracranial aneurysm interventional embolization or craniotomy clipping).DSA or CTA follow-up was performed and mRS scores were recorded.Results Among 237 patients with complete follow-up data, 209 patients had good prognosis(mRS<3),including 191 patients(191/212,90.1%) in the non aneurysmal group and 18 patients(18/25,72.0%) in the aneurysmal group(P<0.05).157 patients with early Suzuki stage had good prognosis.Among them, there were 144 cases(144/233,61.8%) in the non aneurysmal group and 13 cases(13/31,41.9%) in the aneurysmal group(P<0.05).Conclusion Compared to patients with MMD alone, the Suzuki stage of patients with MMD complicated with intracranial aneurysm is higher, which will increase the incidence of postoperative complications and make the prognosis poor.

关 键 词：烟雾病 颅内动脉瘤 颅内外血管搭桥 血管内栓塞术 脑动脉瘤夹闭术 

分 类 号：R651.1[医药卫生—外科学]