Matsushima T, Inoue T, Suzuki S O, Fujii K, Fukui M, Hasuo K
Department of Neurosurgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Neurosurgery. 1992 Sep;31(3):401-5. doi: 10.1227/00006123-199209000-00003.
Either encephaloduroarteriosynangiosis (EDAS) or superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis combined with encephalomyosynangiosis (EMS) has been performed on most of the children with moyamoya disease in our department. EDAS alone was done in the parietal region of 13 sides in 10 patients, and STA-MCA anastomosis with EMS in the parietal region was done on 7 sides in 6 patients. The surgical results of these two different procedures were then compared. Postoperative collateral formation was observed on external carotid angiograms, and the improvement of clinical symptoms was monitored for 1 year after the bypass procedure. STA-MCA anastomosis with EMS was found to be superior to EDAS in both the development of collateral circulation (P less than 0.05) and postoperative clinical improvement (P less than 0.01). EDAS can be done easily and safely on small children with moyamoya disease, but STA-MCA anastomosis with EMS is considered to be more appropriate, whenever possible.
在我们科室，大多数患有烟雾病的儿童都接受了脑-硬脑膜-动脉血管融合术（EDAS）或颞浅动脉-大脑中动脉（STA-MCA）吻合术联合脑-肌-血管融合术（EMS）。10例患者的13侧顶叶区域仅进行了EDAS，6例患者的7侧顶叶区域进行了STA-MCA吻合术联合EMS。然后比较这两种不同手术方法的手术结果。在外颈动脉血管造影上观察术后侧支循环的形成，并在搭桥手术后1年监测临床症状的改善情况。结果发现，STA-MCA吻合术联合EMS在侧支循环形成（P<0.05）和术后临床改善方面（P<0.01）均优于EDAS。EDAS对于患有烟雾病的幼儿来说操作简便且安全，但只要有可能，STA-MCA吻合术联合EMS被认为更为合适。
