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小儿烟雾病的脑-硬脑膜-动脉血管融通术:中国单中心67例经验

Encephaloduroarteriosynangiosis for Pediatric Moyamoya Disease: A Single-Center Experience With 67 Cases in China.

作者信息

Wang Chengjun, Zhao Meng, Wang Jia, Wang Shuo, Zhang Dong, Wang Kai, Zhao Jizong

机构信息

1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China.

2 China National Clinical Research Center for Neurological Diseases, Beijing, PR China.

出版信息

J Child Neurol. 2018 Dec;33(14):901-908. doi: 10.1177/0883073818798515. Epub 2018 Sep 24.

Abstract

The purpose of this study is to investigate the surgical results and long-term outcomes of encephaloduroarteriosynangiosis for moyamoya disease in pediatric patients. We performed a retrospective analysis of 67 pediatric patients with moyamoya disease who underwent encephaloduroarteriosynangiosis in Beijing Tiantan Hospital. The case series included 36 boys and 31 girls. All the patients underwent surgical revascularization, and a total of 93 encephaloduroarteriosynangiosis procedures were performed (41 unilateral, 26 bilateral). The mean follow-up period after surgery was 30 months. During follow-up, ischemic stroke events were detected in 5 patients and the stroke rate for pediatric patients who underwent encephaloduroarteriosynangiosis procedure was 7.1% per patient-years. At the last follow-up, favorable outcomes (modified Rankin Scale score ≤ 2) were observed in 65 cases (97.0%). Our study suggests that long-term surgical outcome of encephaloduroarteriosynangiosis in pediatric moyamoya disease patients is satisfactory, and this technique has a positive impact on the prevention of stroke recurrence.

摘要

本研究旨在探讨小儿烟雾病行脑-硬脑膜-动脉血管融通术的手术效果及长期预后。我们对在北京天坛医院接受脑-硬脑膜-动脉血管融通术的67例小儿烟雾病患者进行了回顾性分析。该病例系列包括36名男孩和31名女孩。所有患者均接受了手术血运重建,共进行了93次脑-硬脑膜-动脉血管融通术(41例单侧,26例双侧)。术后平均随访时间为30个月。随访期间,5例患者发生缺血性卒中事件,接受脑-硬脑膜-动脉血管融通术的小儿患者的卒中发生率为每患者年7.1%。在最后一次随访时,65例(97.0%)患者获得良好预后(改良Rankin量表评分≤2)。我们的研究表明,小儿烟雾病患者脑-硬脑膜-动脉血管融通术的长期手术效果令人满意,该技术对预防卒中复发有积极影响。

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