目的 探讨硬脑膜-动脉血管融通术(EDAS)联合颅骨多点钻孔术治疗缺血型儿童烟雾病(Moyamoya病)的临床疗效.方法 选取近2年手术的缺血型烟雾病患儿42例,分为脑-硬膜-动脉血管融通术(EDAS)组和EDAS联合颅骨多点钻孔术联合组,对术后临床症状改善情况进行比较.结果 单纯EDAS组19例,EDAS联合颅骨多点钻孔术组23例；随访6～ 17个月发现全部手术患者69.05％症状改善,EDAS组改善率52.63％,EDAS联合颅骨多点钻孔术组改善率82.61％,联合手术组较单纯EDAS组效果更好,具有统计学意义,P＜0.05.结论 EDAS联合颅骨多点钻孔术联合应用操作简单,与单纯行EDAS相比,不增加围手术期并发症,有利于改善缺血型烟雾病患儿临床症状.%Objective To evaluate the role of encephalo-duro-arterlosynangiosis combined with multiple burr-hole operation in the treatment of pediatric ischemic Moyamoya disease. Methods A total of 42 patients of ischemic pediatric Moyamoya disease admitted to the hospital over past 2 years were divided into two groups, the encephalo-duro-arterlosynangiosis group (EDAS) and EDAS combined with multiple burr-hole operation group (EDAS +MB). The improvement of symptoms after operation was compared between two groups. Results EDAS was performed in 19 patients, while EDAS + MB in 23 of all 42 patients. Among all the patients during 6-17 months'follow-up, 69.05% got symptom improvement, with 52.63% in EDAS group and 82.61% in EDAS + MB group, respectively. The EDAS + MB group had better prognosis than EDAS group with statistical significance (P <0.05). Conclusion EDAS + MB is beneficial to improve the clinical prognosis of the pediatric ischemic Moyamoya disease without the increase of complications.
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