[1]邱永逸 陈劲草 章剑剑 余 金 许双祥 张继波 王声播.成人烟雾病STA-MCA分流术联合EMS后脑出血和高灌注综合征的关系[J].临床神经外科杂志,2019,16(04):387-389.[doi:10.13798/j.issn.1009-153X.2019.07.002]
 QIU Yong-yi,CHEN Jin-cao,ZHANG Jian-jian,et al.Relationship between postoperative intracranial hemorrhage and cerebral hyperperfusion syndrome after combined bypass in adult patients with Moyamya disease[J].Journal of Clinical Neurosurgery,2019,16(04):387-389.[doi:10.13798/j.issn.1009-153X.2019.07.002]
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成人烟雾病STA-MCA分流术联合EMS后脑出血和高灌注综合征的关系()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年04期
页码:
387-389
栏目:
论著
出版日期:
2019-08-15

文章信息/Info

Title:
Relationship between postoperative intracranial hemorrhage and cerebral hyperperfusion syndrome after combined bypass in adult patients with Moyamya disease
文章编号:
1009-153X(2019)07-0387-03
作者:
邱永逸 陈劲草 章剑剑 余 金 许双祥 张继波 王声播
430071 武汉,武汉大学中南医院神经外科
Author(s):
QIU Yong-yi CHEN Jin-cao ZHANG Jian-jian YU Jin XU Shuang-xiang ZHANG Ji-bo WANG Sheng-bo.
Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan 430071, China
关键词:
烟雾病颞浅动脉-大脑中动脉分流术颞肌贴敷术高灌注综合征脑出血
Keywords:
Moyamoya disease Combined bypass Cerebral hyperperfusion syndrome Postoperative cerebral hemorrhage
分类号:
R 743; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2019.07.002
文献标志码:
A
摘要:
目的 探讨成人烟雾病颞浅动脉(STA)-大脑中动脉(MCA)分流术联合颞肌贴敷术(EMS)后脑出血和高灌注综合征的影响因素及其关系。方法 回顾性分析2015年1月至2018年6月武汉大学中南医院神经外科连续收治的125例成人烟雾病的临床资料,均采用STA-MCA分流术联合EMS治疗。结果 术后发生高灌注综合征10例(7.04%),术后发生脑出血7例(4.93%)。发病早期(发病≤90 d)进行手术具有更高的并发症发生率(P<0.05)。术后发生高灌注综合征10例中,发生脑出血6例(60.0%);术后未发生高灌注综合征132例,发生脑出血1例(0.8%);两者具有显著性差异(P<0.05)。结论 对于成人烟雾病,晚期(发病后>90 d)进行手术治疗,围手术期并发症发生率较低,术后高灌注综合征与术后脑出血关系密切。
Abstract:
Objective To analyze the potential factors related to perioperative complications and the relationship between postoperative intracranial hemorrhage and cerebral hyperperfusion syndrome in the adult patients with Moyamya disease (MD) undergoing the combined bypass. Methods The clinical data of 125 adult patients with MD, who underwent combined bypass in Department of Neurosurgery, Zhongnan Hospital of Wuhan University from MAY, 2015 to January, 2018, were analyzed retrospectively. The relationship of the perioperative complications with the patients' sex and age, Suzuki stage and so on was statistically analyzed. And the relationship of cerebral hyperperfusion syndrome with the postoperative intracranial hemorrhage was analyzed. Results The statistical analysis showed that the rates of occurrences of the perioperative complications were significantly higher in the patients undergoing the combined bypass within 3 months after the initial onset of the disease than those in the patients undergoing the operation over 3 months after the initial onset of the disease (P<0.05). The rate of occurrence of cerebral hemorrhage was significantly higher in the patients with cerebral hyperperfusion syndrome than that in the patients without cerebral hyperperfusion syndrome (P<0.01). Conclusions The results suggests that the patients with MD undergoing the combined bypass within 3 months after initial onset of the disease are easy of suffering the perioprative complications compared with the patients with MD undergoing the combined bypass more than 3 months after initial onset of the disease, and the cerebral hemorrhage is closely related to the cerebral hyperperfusion syndrome in the patients with MD after the combined bypass.

参考文献/References:

[1] Kuroda S, Houkin K. Moyamoya disease: current concepts and future perspectives [J]. Lancet Neurol, 2008, 7: 1056- 1066. [2] Kim JS. Moyamoya disease: epidemiology, clinical features, and diagnosis [J]. J Stroke, 2016, 18: 2-11. [3] Kim T, Oh CW, Bang JS. Moyamoya Disease: treatment and outcomes [J]. J Stroke, 2016, 18(1): 21-30. [4] Zhao Y, Zhang Q, Zhang D, et al. Effect of aspirin in post- operative management of adult ischemic moyamoya disease [J]. World Neurosurg, 2017, 105: 728-731. [5] Kronenburg A, Braun KP, van der Zwan A, et al. Recent advances in moyamoya disease: pathophysiology and treatment [J]. Curr Neurol Neurosci Rep, 2014, 14: 423. [6] Pandey P, Steinberg GK. Neurosurgical advances in the treatment of moyamoya disease [J]. Stroke, 2011, 42: 3304- 3310. [7] Tokairin K, Kazumata K, Uchino H, et al. Postoperative intracerebral hemorrhage after combined revascularization surgery in moyamoya disease: profiles and clinical associa- tions [J]. World Neurosurg, 2018, 120: e593-e600. [8] Xu S, Zhang J, Wang S, et al. The optimum operative time of revascularization for patients with Moyamoya Disease following acute onset [J]. World Neurosurg, 2018, 114, e412-e416. [9] Fujimura M, Tominaga T. Significance of cerebral blood flow analysis in the acute stage after revascularization surgery for Moyamoya disease [J]. Neurol Med Chir (Tokyo), 2015, 55: 775-781. [10] Kim JE, Oh CW, Kwon OK, et al. Transient hyperperfusion after superficial temporal artery - middle cerebral artery bypass surgery as a possible cause of postoperative tran- sient neurological deterioration [J]. Cerebrovasc Dis, 2008, 25: 580-586. [11] Nomura S, Yamaguchi K, Ishikawa T, et al. Factors of delayed hyperperfusion and the importance of repeated cerebral blood flow evaluation for hyperperfusion after direct bypass for Moyamoya Disease [J]. World Neurosurg, 2018, 118: e468-e472. [12] Ishikawa T, Yamaguchi K, Kawashima A, et al. Predicting the occurrence of hemorrhagic cerebral hyperperfusion syndrome using regional cerebral blood flow after direct bypass surgery in patients with Moyamoya Disease [J]. World Neurosurg, 2018, 119: e750-e756.

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备注/Memo

备注/Memo:
(2019-01-02收稿,2019-04-17修回)基金项目:国家自然科学基金(81571146;81671157)通讯作者:陈劲草,E-mail:chenjincao@hotmail.com
更新日期/Last Update: 1900-01-01