Nomura Shunsuke, Kawashima Akitsugu, Ishiguro Taichi, Hashimoto Kazutoshi, Hodotsuka Kenichi, Nakamura Akikazu, Kuwano Atsushi, Tanaka Yukiko, Murakami Masato, Shiono Teppei, Kawamata Takakazu
Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
World Neurosurg. 2022 Mar;159:e267-e272. doi: 10.1016/j.wneu.2021.12.043. Epub 2021 Dec 18.
Postoperative intracerebral hemorrhage (ICH) after direct bypass surgery for Moyamoya disease could contribute to neurologic deterioration. The aim of this study was to evaluate the effectiveness of 5-day bed rest in reducing the occurrence of postoperative ICH.
This study included 122 consecutive hemispheres in 87 Japanese adult MMD patients, composed of 80 control hemispheres from historical data and 42 hemispheres after 5-day bed rest. They all underwent direct bypass surgery. The incidence of postoperative ICH and neurologic deterioration assessed via the modified Rankin Scale were investigated and statistically analyzed.
Postoperative ICH was observed in 9 out of the 80 (11.3%) control patients, but not in the 42 patients with 5-day bed rest. The incidence of postoperative ICH and neurologic deterioration via the modified Rankin Scale were significantly different between the 2 groups (P = 0.0268 and 0.0078, respectively). Univariate logistic analysis revealed that 5-day bed rest significantly reduced the incidence of postoperative ICH (P = 0.0048).
Five-day bed rest after direct bypass surgery dramatically can reduce the incidence of postoperative ICH and neurologic deterioration after direct bypass surgery.
烟雾病直接搭桥手术后的术后脑出血（ICH）可能导致神经功能恶化。本研究的目的是评估5天卧床休息在降低术后脑出血发生率方面的有效性。
本研究纳入了87例日本成年烟雾病患者的122个连续半球，包括历史数据中的80个对照半球和5天卧床休息后的42个半球。他们均接受了直接搭桥手术。研究并统计分析了通过改良Rankin量表评估的术后脑出血发生率和神经功能恶化情况。
80例对照患者中有9例（11.3%）出现术后脑出血，而42例5天卧床休息的患者中未出现。两组之间通过改良Rankin量表评估的术后脑出血发生率和神经功能恶化情况有显著差异（分别为P = 0.0268和0.0078）。单因素逻辑分析显示，5天卧床休息显著降低了术后脑出血的发生率（P = 0.0048）。
直接搭桥手术后5天卧床休息可显著降低术后脑出血的发生率以及直接搭桥手术后神经功能恶化的发生率。
