摘要
目的报告施行改进的颅外颅内动脉吻合及脑肌血管连通融合相结合的血供重建术，治疗１５岁以下儿童烟雾病２２６例的远期治疗作用。方法术后经８年（平均１５５年）以上随访，经脑血管造影复查及ＭＲＩ、头颅ＣＴ扫描、经颅多普勒超声（ＴＣＤ）颅内多条血管探测检查，以及对临床神经系统症状与术前对比、格拉斯哥预后测评（ＧＯＳ）、Ｔａｆｔ智商测定。结果２２６例中，６４例（２８％）神经系统症状完全恢复，６９例（３１％）显著进步，４６例（２０％）轻度进步，４３例（１９％）无变化，４例（２％）死亡，有效率７９％。结论改进的颅外颅内动脉吻合及脑肌血管连通融合相结合的方法，对改善儿童烟雾病脑缺血状态有明显作用，研究发现预后结果与术前脑血管损害程度分期有相关性，损害程度较轻的Ⅰ～Ⅲ期预后好，智商高，损害严重的Ⅳ～Ⅴ期预后差。
Objective To study the long term results of 226 patients with moyamoya disease ased below 15 years and to report the modified method of extra intracranial arterial anastomosis and encephalo myo arterio synagiosis,etc. Method The mean follow up period was 15.5 years(rang 8 19 years). The results were obtained from the pre and postoperative cerebral angiographic examination, MRI, CT, cerebrovascular Doppler ultrasonography, Glasgow Outcome Scale (GOS), intelligence quotient (IQ) as classified by Taft and neurological symptoms. Result Of the 226 patients with hildhood moyamoya disease, 64 (28%)rcovered in completely, 69 (31%) in improved markedly, and 46 (20%) improvemed slightly.43 patients (19%) had no changes and 4 (2%) died. The effective rate of the operation was 79%. Conclusion The modified direct anastomosis and encephalo myo arterio synagiosis played a role in this improvement by increasing CBF after the operation. A significant correlation is found between the postoperative effect and the stages of preoperative angiograms.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1998年第6期360-362,I071,共4页
Chinese Journal of Surgery
关键词
儿童
血供重建
烟雾病
脑缺血
Cerebral artery diseases Child Prognosis Moyamoya disease
