蛛网膜对儿童缺血型烟雾病间接颅内外血管重建术疗效的影响

发布时间：2019-04-24 18:55

【摘要】：目的探讨儿童缺血型烟雾病行间接颅内外血管重建术时打开蛛网膜对术后血管重建疗效的影响。方法回顾性分析2010年8月至2015年11月21例(28侧)行间接颅内外血管重建术的儿童缺血型烟雾病患者临床资料,术中打开蛛网膜组12例(18侧),术中未打开蛛网膜组9例(10侧);术后12个月时复查MRI和DSA以及结合临床症状来评价打开蛛网膜与未打开蛛网膜组颅内外血管重建术后疗效。结果两组术后均有不同程度侧支循环形成及PWI改善,术中打开组术后12月时DSA侧支循环的良好及一般率达94.44%明显优于未打开组的60%,且构成的差异有统计学意义(P0.05);两组术后临床症状改善差异无统计学意义,而术中打开蛛网膜组的优秀及良好率达88.89%,高于未打开组的60%;两组并发症差异无统计学意义。结论术中打开蛛网膜较未打开者可能更有利于改善儿童缺血型烟雾病间接颅内外血管重建术的疗效。
[Abstract]:Objective to investigate the effect of arachnoid opening on postoperative vascular reconstruction in children with ischemic moyamoya disease. Methods the clinical data of 21 children (28 sides) who underwent indirect extracranial and extracranial vascular reconstruction from August 2010 to November 2015 were retrospectively analyzed. There were 12 cases (18 sides) in the group of opening arachnoid membrane during the operation. 9 cases (10 sides) in the group of unopened arachnoid membrane during operation; At 12 months after operation, MRI, DSA and clinical symptoms were used to evaluate the effect of extracranial and extracranial vascular reconstruction in arachnoid and unopened arachnoid group. Results there were different degrees of collateral circulation formation and PWI improvement in both groups. The good and general rate of DSA collateral circulation in the open group was 94.44% at 12 months after operation, which was significantly higher than that in the unopened group (60%). And the composition of the difference was statistically significant (P0.05); There was no significant difference in the improvement of clinical symptoms between the two groups, but the excellent and good rate in the group with cobwebs opened during operation was 88.89%, which was higher than that in the group without opening the membrane, and there was no significant difference in complications between the two groups. Conclusion Arachnoid opening during operation may be more beneficial to improve the outcome of indirect extracranial vascular reconstruction in children with ischemic moyamoya disease than those without arachnoid opening.
【作者单位】：中南大学湘雅医院神经外科;中南大学湘雅医院儿科;中南大学湘雅医院手术室;
【分类号】：R726.5

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