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论著:儿童烟雾病脑血管重建术后脑血流状况与预后的关系
Association between Hemodynamics and Efficacy of Revascularization in Childhood Moyamoya Disease
任洪波 刘斌 张山 贾海波 刘吉祥
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作者单位:河北省邯郸市中心医院神经外一科
中文关键字:经颅多普勒;烟雾病;脑血流;脑血管重建术
英文关键字:Transcranial Doppler; Moyamoya disease; Cerebral blood flow; Cerebral revascularization
中文摘要:目的:探讨儿童烟雾病脑血管重建术后脑血流状况与临床预后的相关性。方法:32例实施脑 硬脑膜 动脉血管贴敷术(EDAS)的儿童烟雾病患者在手术前及术后6至12个月分别行经颅多普勒超声(TCD)检测。对患者手术前、后颞浅动脉流速、大脑中动脉(MCA)主干及远端峰值流速 (Vp)、舒张期流速 (Vd)、平均流速 (Vm )及搏动指数(P I)结果进行对比,分析手术前、后脑血流状况变化特点及其与临床预后的关系。结果:在32例患者中,术后脑血流明显改善者26例,其中临床预后佳者16例,良7例,一般3例;脑血流无改善者6例,其中临床预后佳者0例,良2例,一般3例,差1例。脑血流状况与临床预后间有显著相关性 (P<0.05)。结论:TCD可以检测儿童烟雾病患者EDAS手术前后的脑血流变化,EDAS术后患者脑血流状况与其临床预后具有相关性。
英文摘要:Objective:To investigate the association between hemodynamics and efficacy of revascularization in childhood moyamoya disease. Methods:32 children with moyamoya disease were enrolled in this study. All patients underwent transcranial cerebral Doppler(TCD) before encephalo duro arterio synangiosis (EDAS) and at 6 12 months after EDAS. The data of Peak velocity (Vp), diastolic velocity (Vd), mean velocity (Vm) and pulsatility index (PI) of MCA before and after EDAS have been analyzed. Results: Among the 26 cases whose hemodynamics has been significantly improved after surgery, the clinical prognosis were excellent in 16 cases, good in 7 cases, fair in 3 cases, and poor in 0 case. Among the 6 cases whose hemodynamics has not been improved after surgery, the clinical outcomes were excellent in 0 case, good in 2 cases, fair 3 cases, and poor in 1 case. The association between the hemodynamics after EDAS and the efficacy of revascularization was significant(P<0.05). Conclusions: TCD can detect changes of cerebral blood flow in patients with childhood moyamoya disease and help to predict the efficacy of EDAS.
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