间接血流重建术对出血型烟雾病主要出血机制的临床干预

Clinical intervention study by indirect cerebral revascularization to main bleeding mechanisms in hemorrhagic Moyamoya's disease

目的探讨间接血流重建术对出血型烟雾病主要出血机制（＂烟雾血管＂）消长关系的影响因素和对再出血的干预价值。方法介绍9例出血型烟雾病经间接血流重建术后,其烟雾血管的演化与再出血干预的影响关系和影响因素,并结合文献复习。结果 1例一侧出血型烟雾病术后一年另一侧新发出血,其余8例术后均无再出血发生。随访时间1.3~9.5年,平均3.1年。结论对出血型烟雾病采取积极的间接血流重建术干预,初步评估可以明显降低其再出血的发生率和相关性神经功能的损害。

Objective To discuss the effective factors of the indirect revascularization to growth and atrophy relations of ＂Maoyamaoya vessels＂in the patients with hemorrhagic Moyamoya＇ s disease,and to explore its value for treatment. Methods To introduce 9 cases of patients with hemorrhagic Moyamoya＇ s disease treated by indirect revascularization,which was to compare the effective relations and factors to the ＂Maoyamaoya vessels ＂evolution with re-hemorrhage intervene. Also,relative literatures were reviewed. Results One patient with hemorrhage of controlled side 1 year after the revascularization to the original hemorrhage,others without re-hemorrhage. Follow-up was performed for 1. 3 to 9. 5（ mean 3. 1） years postoperatively. Conclusion It is effective by initial estimate positively to take to the revascularization for the patients with hemorrhagic Moyamoya＇ s disease,which can reduce the rate of re-hemorrhage and relative damages to nerves.