颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病

Therapeutic effect of multiple burr - hole operation combined with dural inversion and periosteal synangiosis for moyamoya disease

目的初步探讨应用颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病的疗效。方法对25例烟雾病患者行颅骨多处钻孔硬膜翻转并骨膜贴敷术，术后随访3个月-3年。结果20例缺血型患者术前原有症状术后均好转，5例出血型患者术后未发生再出血。9例患者行DSA复查，造影结果显示38个骨孔均有新生血管生长，缺血区血运改善。手术并发症包括硬膜下血肿1例、暂时性神经功能障碍5例、发热1例。结论单独应用颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病是简单、安全、有效的。

Objective To explore the therapeutic effect of multiple burr - hole operation combined with dural inversion and periosteal synangiosis for moyamoya disease. Methods The multiple burr - hole operation combined with dural inversion and periosteal synangiosis was performed on 25 patients with moyamoya disease, which were followed up for three months to three years. Results The clinical symptoms of the 20 patients with ischemic moyamoya disease gradually improved after the operations. There was no postoperative rebleeding in the 5 patients with hemorrhagic moyamoya disease. Nine patients were reexamined by digital subtraction angiogram （DSA）. The postoperative DSA results revealed there was apparent neovascularization in all the 38 burr - holes and the revascularization of the ischemic cerebral tissue was obtained. The postoperative complications included one case of subdural hematoma, 5 cases of postoperative temporary neurological deficits and 1 case of fever. Conclusion Multiple burr - hole operation combined with dural inversion and periosteal synangiosis is a simple, safe and effective treatment method for moyamoya disease as a sole treatment without supplementary revascularization procedures.