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目的探讨颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病的临床疗效。方法 19例烟雾病患者以缺血首发17例,出血首发2例,均行颅骨多处钻孔硬膜翻转并骨膜贴敷术,术后随访2~48个月,随访数据进行统计学分析。结果缺血型患者中TIA患者术后TIA未再发作,脑梗塞患者术后原有缺血症状改善或消失。2例出血型患者术后随访至今未发生再出血。10例患者术后行DSA复查,45个骨孔均有新生血管向颅内生长,新生血管来自脑膜中动脉和颞浅动脉。1例伴发动脉瘤患者术后DSA复查动脉瘤未显影。结论颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病简便、安全、有效。
Objective To investigate the clinical effects of multiple skull drilling perforation and periosteal sticking on moyamoya disease. Methods Twenty-nine patients with moyamoya disease were included in this study. Twenty-seven patients with moyamoya disease and two patients with hemorrhage were performed. All patients underwent craniotomy and periosteal sticking with multiple drilling of skull. The patients were followed up for 2 to 48 months. The follow-up data were used for statistical analysis. Results TIA in ischemic patients did not recurred after TIA. The symptoms of ischemic stroke were improved or disappeared in patients with cerebral infarction. Two cases of hemorrhagic patients were followed up so far no recurrence of bleeding. Ten patients underwent postoperative DSA review, 45 bone neovasculature were intracranial growth, neovascularization from the middle meningeal artery and superficial temporal artery. One case of aneurysm with aneurysm was not developed after DSA. Conclusion Multiple craniotomy with perforation of the skull and periosteal sticking for the treatment of moyamoya disease is simple, safe and effective.