摘要
目的探讨颞浅动脉贴敷术治疗儿童烟雾病的临床疗效。方法回顾性分析2020年1月至2022年8月山东大学附属儿童医院神经外科收治的18例(28侧手术)烟雾病患儿临床资料,通过手术成功率、术后并发症发生率、临床症状改善情况及影像学变化等指标,评估颞浅动脉贴敷术治疗儿童烟雾病的临床疗效。结果18例患儿共完成28侧颞浅动脉贴敷手术,手术成功率100%;术后无一例出现新发脑出血、脑梗塞、癫痫发作等严重并发症,1例术后出现运动性失语、张口困难,1例首次手术后出现短暂言语不清、对侧手术后出现一过性面部抽动,1例术后因情绪激动出现右上肢一过性无力;均经对症处理或积极床旁康复治疗后好转。术后3个月颅脑CT血管造影及MRI提示出现新生血管,脑灌注明显改善。随访3~31个月,改良Rankin评分量表评级结果显示,0级13例,1级3例,2级1例,4级1例。结论颞浅动脉贴敷术治疗低龄儿童烟雾病成功率高,并发症少,临床表现及脑血流改善明显,疗效确切。
Objective To explore the clinical efficacy of superficial temporal artery dressing for Moyamoya disease(MMD)in children.Methods From January 2020 to August 2022,the clinical data were retrospectively reviewed for 18 hospitalized MMD children at Affiliated Children's Hospital of Shandong University.Clinical efficacies were evaluated by success rate,postoperative complication rate,improvements of clinical symptoms and changes of imaging features.Results A total of 28 operations were completed successfully.During hospitalization,there was no occurrence of such serious complications as cerebral hemorrhage,cerebral infarction or seizure.However,one child of motor aphasia failed to open mouth.One case of had brief slurred speech after an initial operation and developed transient facial tics after contralateral operation.And another child developed transient weakness of right upper arm due to emotional agitation.Cranial MRA after Month 3 hinted at neovascularization.Cerebral perfusion significantly improved.During a follow-up period of(3-31)month,mRS grade was 0(n=13),1(n=3),2(n=1)and 4(n=1).Conclusions For MMD in children,superficial temporal artery patching offers a high success rate,few complications,obvious symptomatic improvements and a definite efficacy.
作者
王伟伟
谢仕刚
刘渤
韩晓
岳喜赞
古龙
张东
王广宇
Wang Weiwei;Xie Shigang;Liu Bo;Han Xiao;Yue Xizan;Gu Long;Zhang Dong;Wang Guangyu(Department of Neurosurgery,Municipal Children's Hospital,Affiliated Children's Hospital of Shandong University,Jinan 250022,China;Department of Neurosurgery,Affiliated Beijing Tiantang Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床小儿外科杂志》
CAS
CSCD
北大核心
2024年第4期367-371,共5页
Journal of Clinical Pediatric Surgery
关键词
烟雾病
动脉
外科学
治疗结果
儿童
Moyamoya Disease
Arteries,Surgery
Treatment Outcome
Child
