[1]欧阳光,黄书岚,徐海涛,等.脑血运重建治疗缺血性烟雾病手术时机的选择[J].临床神经外科杂志,2019,16(5):397-401.[doi:10.3969/j.issn.1672-7770.2019.05.006]
 OUYANG Guang,HUANG Shu-lan,XU Hai-tao,et al.Optimum operation time of revascularization for ischemic moyamoya disease[J].Journal of Clinical Neurosurgery,2019,16(5):397-401.[doi:10.3969/j.issn.1672-7770.2019.05.006]
点击复制

脑血运重建治疗缺血性烟雾病手术时机的选择 ()
分享到:

《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第5期
页码:
397-401
栏目:
脑血管病专题
出版日期:
2019-10-15

文章信息/Info

Title:
Optimum operation time of revascularization for ischemic moyamoya disease
作者:
欧阳光黄书岚徐海涛余小祥
430060 武汉,武汉市第三医院神经外科(欧阳光,余小祥);武汉大学人民医院神经外科(黄书岚,徐海涛)
Author(s):
OUYANG Guang HUANG Shu-lan XU Hai-tao et al.
Department of Neurosurgery, The Third Hospital of Wuhan, Wuhan 430060, China
关键词:
烟雾病血运重建手术时机
Keywords:
moyamoya disease revascularization timing of operation
分类号:
R651.1
DOI:
10.3969/j.issn.1672-7770.2019.05.006
文献标志码:
A
摘要:
【摘要】目的探讨脑血运重建术治疗缺血性烟雾病的最佳手术时机。方法回顾性分析武汉大学人民医院2016年7月—2018年5月收治的41例缺血性烟雾病患者的临床资料。所有患者均行颞浅-大脑中动脉搭桥+颞肌贴敷术,依据缺血性卒中发生时间与手术之间的时间间隔,将患者分为早期组(1~3个月,17例)和晚期组(>3个月,24例)。分析比较两组患者术后3个月脑灌注改善率及神经功能缺损恢复状况;以及术后并发症(脑出血、脑梗死、过度灌注)的发生率。结果与晚期组相比,早期组患者术后3个月的脑灌注改善率更高,美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分明显降低,差异均有统计学意义(P<0.001,P=0.01)。术后总的并发症(包括过度灌注、脑出血、脑梗死)发生率,早期组为52.9%,晚期组为54.2%,两组的差异无统计学意义(P>0.05)。结论缺血性烟雾病患者卒中事件后1~3个月内行脑血运重建术,对于改善患者脑灌注和神经功能恢复更有效,并且不增加术后并发症发生的风险。
Abstract:
Abstract: ObjectiveTo discuss the optimum operation time for ischemic moyamoya disease. MethodsThe clinical data of 41 patients with ischemic moyamoya disease underwent revascularization at the Department of Neurosurgery, Renmin Hospital of Wuhan University from June 2016 to May 2018 were analyzed retrospectively. Considering the time interval between acute onset of moyamoya disease and surgery, all patients were divided into early group and later group(>90 days between MMD onset and surgery). The post-operation complication(Cerebral hemorrhage, Cerebral infarction, Cerebral hyperperfusion), and the effective of operation(the score of NIHSS, the improvement of perfusion) were compared between groups to estimate optimum operative time of revascularization. Results Compared with the later group, the difference was statistically significant in early group about the improvement of perfusion and neurofunction(P<0.05), the values were 0.00 and 0.01, respectively. There was no obvious difference about post-operation complication between early group(52.9%) and later(54.2%) group. ConclusionsIt seems more reasonable to operate for early revasculization for patients with ischemic moyamoya disease.It can improve surgical efficacy and the risk of postoperative hyperperfusion, cerebral infarction and cerebral hemorrhage may not increase.

相似文献/References:

[1]陈军,李爱民,陈震.脑血流重建术治疗出血型烟雾病[J].临床神经外科杂志,2016,(01):21.
[2]周平,邓燕,王辉,等.磁共振灌注成像在联合血管重建术治疗烟雾病中的应用[J].临床神经外科杂志,2016,(03):197.
 ZHOU Ping,DENG Yan,WANG Hui,et al.The value of MR perfusion imaging in treatment of moyamoya disease treated by combined revascularization[J].Journal of Clinical Neurosurgery,2016,(5):197.
[3]蔡瑜,顾威庭,李锋,等.间接血管重建术治疗成人烟雾病[J].临床神经外科杂志,2016,(06):439.
 CAI Yu,GU Wei-ting,LI Feng,et al.Appliction of encephalo-duro-arterio-synangiosis in treatment of adults Moyamoya disease[J].Journal of Clinical Neurosurgery,2016,(5):439.
[4]何雪阳,张晋宁,蔡永辉,等.烟雾病合并动脉瘤栓塞治疗6例及文献复习[J].临床神经外科杂志,2017,14(01):52.
 HE Xue-yang,ZHANG Jin-ning,CAI Yong-hui,et al.Endovascular treatment of intracranial aneurysms associated with moyamoya disease[J].Journal of Clinical Neurosurgery,2017,14(5):52.
[5]朱耀祖,陈锋,王旭,等.颞浅动脉-大脑中动脉分支吻合联合脑-硬脑膜-肌肉血管融合术治疗烟雾病的效果及对脑血循环的影响[J].临床神经外科杂志,2019,16(5):402.[doi:10.3969/j.issn.1672-7770.2019.05.007]
 ZHU Yao-zu,CHEN Feng,WANG Xu,et al.Comparison of STA-MCA+EDMS and conservative therapy for moyamoya disease and its effect on cerebral circulation[J].Journal of Clinical Neurosurgery,2019,16(5):402.[doi:10.3969/j.issn.1672-7770.2019.05.007]

更新日期/Last Update: 2019-10-15