硬脑膜动脉血管融通术治疗成人烟雾病

目的 探讨成人烟雾病的临床特征,观察脑硬膜动脉血管融通术(EDAS)对成人烟雾病的治疗作用.方法 回顾分析在我院接受EDAS治疗的312例成人烟雾病患者的临床资料.结果 缺血型和出血型患者分别占79.8%(249例)、20.2%(63例).2例出血型患者术后发生再出血;219例缺血型患者术后临床症状明显缓解或完全消失.术后76.2%的患者糖代谢明显改善;56.6%的患者显示良好的颅内外血管重建,糖代谢减低、低龄、缺血型患者预示更好的血管重建.结论 中国成人烟雾病患者有自身的发病特征;应用EDAS术能明显改善和预防成人烟雾病患者脑缺血发作,对出血型患者再发脑出血也可能有一定的预防作用.

Efficacy of encephalo - duro - arterio - synangiosis in adult moyamoya disease

Objective To determine the clinical features and the efficacy of encephalo - duro -arterio - synangiosis( EDAS) in adult Moyamoya disease( MMD). Method 312 patients with adult MMD admitted to our hospital from December 2002 to September 2008 were retrospectively reviewed. All patients were underwent EDAS and followed up for a 26 - month mean period. Results The initial symptom was cerebral ischemia in 249 patients ( 79. 8% ) and cerebral hemorrhage in 63 patients ( 20. 2% ) . After operation,2 cases in 63 patients with hemorrhage had rebleeding and one died,and 219 cases in 249 patients with ischemia had relief obviously. PET examinations showed post - operative glucose metabolism was increased clearly in 157 of 206 hemispheres (76. 2% ). DSA examinations revealed a good revascularization on 47 of 83 hemispheres (56. 6% ) after operation. Multivariate logistic regression analysis showed that hypometabolism,youngers and ischemic type indicated better revascularization. Conclusions Adult patients in China with Moyamoya disease present with different clinical features compared with other countries. Surgical treatment with EDAS seems to be effective in adult MMD in terms of clinical improvement.