临床神经外科杂志2016，Vol.13Issue(1)：21-23,27,4.DOI:10.3969/j.issn.1672-7770.2016.01.006
脑血流重建术治疗出血型烟雾病
Treatment of arterial anastamoses for haemorrhagic type moyamoya disease
摘要
Abstract
Objective To study the outcomes of patients with hemorrhagic type moyamoya disease(MMD) and the effects of arterial anastamoses treatment in order to reduce its re -bleeding rate.Methods 82 patients with haemorrhagic type MMD were diagnosed with DSA and CT scan . There were 10 cases(12.2%) of aneurysms,18 (21.9%) intracerebral hemorrhage (ICH) without aneurysms,20 (24.4%) intraventricular hemorrhage (IVH), 38(46.3%) ICH and IVH,6 (7.3%) subarachnoid hemorrhage ( SAH ) .Surgical treatment was performed in 48 patients and conservative treatment was done in 34.The data of clinical , imaged and situation of re-bleeding in all patients were analyzed .Results This group patients were followed up over a period ranging from 0.6 to 12 years (mean 7.8 years).The outcomes were excellent in 56 cases(68.3%),good in 8(9.8%),poor in 4 (4.9%) and 12 (14.6%)died.During the follow-up period,recurrent bleeding occurred in 14 cases (17.1%).The interval to recurrent bleeding ranged from 0.3 ~10 years.The rate of recurrent bleeding was 17.1%.The mortality of which was 85.7%.Conclusion The most important cause of death is cerebral hemorrhage in patients with MMD .Recurrent bleeding was a major cause of poor prognosis ,mobility and mortality in patients with the haemorrhagic type MMD patients .Direct and indirect arterial anastamoses reduced the risk of re bleeding , and the long-term prognosis of surgical treatment was better than conservative treatment .关键词
烟雾病/脑出血/血管重建术/保守治疗/预后/再出血Key words
moyamoya disease/intracerebral hemorrhage/arterial anastamoses/conservative treatment/outcome/recurrent hemorrhage分类
医药卫生引用本文复制引用
陈军,李爱民,陈震,吴海滨,张洪伟,王富元,刘希光..脑血流重建术治疗出血型烟雾病[J].临床神经外科杂志,2016,13(1):21-23,27,4.基金项目
连云港市卫生局基金资助项目(1201) （1201）
