中国脑血管病杂志
中國腦血管病雜誌
중국뇌혈관병잡지
CHINESE JOURNAL OF CEREBROVASCULAR DISEASES
2014年
6期
284-288
,共5页
脑底异常血管网病%儿童%脑梗死%预后%脑硬膜颞浅动脉融通术
腦底異常血管網病%兒童%腦梗死%預後%腦硬膜顳淺動脈融通術
뇌저이상혈관망병%인동%뇌경사%예후%뇌경막섭천동맥융통술
Moyamoya disease%Children%Brain infarction%Prognosis%Encephaloduroarteriosy nangiosis
目的：探讨儿童烟雾病临床特征及实施脑硬膜颞浅动脉融通术( EDAS )的预后。方法根据患者第1次手术时的年龄,将2004年1月-2010年12月317例接受EDAS的儿童烟雾病患者分为3组：幼儿组(年龄<3岁,16例),学龄前组(年龄3~6岁,42例),青少年组(>6~17岁,259例)。回顾性分析患者的临床资料并对手术疗效进行评估。结果(1)3组患者中,手术干预前脑梗死发生率幼儿组(81．2%,13/16)和学龄前组(69．0%,29/42)显著高于青少年组(48．3%,125/259),差异有统计学意义(χ2=11．741,P<0．01)；(2)手术干预前原脑梗死体积增大或在不同部位脑梗死再发率幼儿组(62．5%,10/16)高于学龄前组(31．0%,13/42)和青少年组(3．9%,10/259),差异有统计学意义(χ2=77．437,P<0．01)；(3)总体预后优良率为86．4%(274/317),3组间比较,差异有统计学意义(χ2=9．026,P<0．02)。结论烟雾病幼儿患者病情进展迅速,临床预后差；对儿童烟雾病患者及早实施EDAS安全有效。
目的：探討兒童煙霧病臨床特徵及實施腦硬膜顳淺動脈融通術( EDAS )的預後。方法根據患者第1次手術時的年齡,將2004年1月-2010年12月317例接受EDAS的兒童煙霧病患者分為3組：幼兒組(年齡<3歲,16例),學齡前組(年齡3~6歲,42例),青少年組(>6~17歲,259例)。迴顧性分析患者的臨床資料併對手術療效進行評估。結果(1)3組患者中,手術榦預前腦梗死髮生率幼兒組(81．2%,13/16)和學齡前組(69．0%,29/42)顯著高于青少年組(48．3%,125/259),差異有統計學意義(χ2=11．741,P<0．01)；(2)手術榦預前原腦梗死體積增大或在不同部位腦梗死再髮率幼兒組(62．5%,10/16)高于學齡前組(31．0%,13/42)和青少年組(3．9%,10/259),差異有統計學意義(χ2=77．437,P<0．01)；(3)總體預後優良率為86．4%(274/317),3組間比較,差異有統計學意義(χ2=9．026,P<0．02)。結論煙霧病幼兒患者病情進展迅速,臨床預後差；對兒童煙霧病患者及早實施EDAS安全有效。
목적：탐토인동연무병림상특정급실시뇌경막섭천동맥융통술( EDAS )적예후。방법근거환자제1차수술시적년령,장2004년1월-2010년12월317례접수EDAS적인동연무병환자분위3조：유인조(년령<3세,16례),학령전조(년령3~6세,42례),청소년조(>6~17세,259례)。회고성분석환자적림상자료병대수술료효진행평고。결과(1)3조환자중,수술간예전뇌경사발생솔유인조(81．2%,13/16)화학령전조(69．0%,29/42)현저고우청소년조(48．3%,125/259),차이유통계학의의(χ2=11．741,P<0．01)；(2)수술간예전원뇌경사체적증대혹재불동부위뇌경사재발솔유인조(62．5%,10/16)고우학령전조(31．0%,13/42)화청소년조(3．9%,10/259),차이유통계학의의(χ2=77．437,P<0．01)；(3)총체예후우량솔위86．4%(274/317),3조간비교,차이유통계학의의(χ2=9．026,P<0．02)。결론연무병유인환자병정진전신속,림상예후차；대인동연무병환자급조실시EDAS안전유효。
Objective To investigate the clinical features of moyamoya disease in children and the prognosis of encephaloduroarteriosynangiosis ( EDAS) . Methods According to the age of first operated patients,317 children with moyamoya disease who received EDAS from January 2004 to December 2010 were divided into 3 groups:infant group (n=16,<3 years of age),preschool group (n=42,3 to 6 years of age),and adolescent group (n=259,6 to 17 years of age). The clinical data and the efficacy of operation of the patients were analyzed retrospectively. Results (1) Among the 3 groups of patients,the incidences of cerebral infarction in the infant group (81. 2%,13/16) or the preschool group (69. 0%,29/42) before procedure were significantly higher than the adolescent group (48. 3%,125/259). There were significant differences (χ2 =11. 741,P<0. 01). (2) Before surgical intervention,the infarct volume enlargement or the recurrence of infarction rate at different parts of brain in the infant group (62. 5%,10/16) was higher than that of the preschool group (31. 0%,13/42) and adolescent group (3. 9%,10/259). There was significant difference (χ2 =77. 437,P <0. 01). (3) The overall rate of favourable prognosis was 86. 4% (274/317). There were significant differences between the 3 groups (χ2 =9. 026,P<0.02). Conclusion The conditions of children with moyamoya disease progresses rapidly and their clinical prognosis is poor. It is safe and effective to perform EDAS early moyamoya disease in children.
