多点颅骨钻孔手术治疗儿童缺血型烟雾病EDAS术后未缓解患者

The multiple burr-hole operation for pediatric ischemic Moyamoya disease treated with EDAS without remission

目的探讨儿童缺血型烟雾病(Moyamoya病)经脑-硬膜-动脉血管融通术(EDAS)手术治疗,但症状未缓解的患者,行多点颅骨钻孔术的临床疗效。方法选取近2年收治的EDAS术后6个月以上症状未缓解的儿童缺血型烟雾病患者20例,行多点颅骨钻孔手术(MB)13例。未行二次手术,仅予临床观察7例,6个月后复查作为对照,对两组病例的临床症状改善情况进行比较。结果未手术组7例,临床症状改善率为14.28%;行颅骨多点钻孔术组13例,症状改善率53.85%,差异明显,具有统计学意义(P<0.05)。二次手术组围手术期无并发症。结论部分烟雾病患儿EDSA手术效果欠佳,多点颅骨钻孔手术可以作为EDAS术后症状未缓解或加重患者的进一步治疗措施,效果良好。

Objective The role of multiple burr-hole operation （ MB ） for the treatment of ischemic pediatric Moyamoya disease that had failed by the encephalo-duro-arterlosynangiosis operation （EDAS） is evaluated. Methods A total of 20 pediatric patients with ischemie Moyamoya disease that had failed by the encephalo-duro-arterlosynangiosis operation enrolled over past 2 years were divided into two groups, MB group and non-operative group. The improvement of symptoms after operation was compared between two groups after 6 months. Results In MB group 53. 85% of patients had the symptom improvements at 6 months after the operation; 14.28% of patients got the symptoms improvements in non-operative group. There was significant difference in the improvement rates between MB group and non-operative group （P 〈0.05 ）. Conclusion Multiple burr-hole operation （MB）can be used for the pediatric patients with Moyamoya disease who have poor results after EDAS.