[1]李　舜　唐晓平　文　军　罗仁国　张　柳　段军伟　彭　华　赵　龙.成人出血型烟雾病合并颅内动脉瘤的诊治及预后分析[J].中国临床神经外科杂志,2017,(04):213-215.[doi:10.13798/j.issn.1009-153X.2017.04.002]
　LI Shun,TANG Xiao-ping,WEN Jun,et al.Diagnosis, treatment and prognosis of intracranial aneurysms in adults with hemorrhagic moyamoya disease[J].,2017,(04):213-215.[doi:10.13798/j.issn.1009-153X.2017.04.002]
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成人出血型烟雾病合并颅内动脉瘤的诊治及预后分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年04期
页码:
213-215
栏目:
论著
出版日期:
2017-04-25

文章信息/Info

Title:
Diagnosis, treatment and prognosis of intracranial aneurysms in adults with hemorrhagic moyamoya disease
文章编号:
1009-153X（2017）04-0213-03
作者:
李　舜　唐晓平　文　军　罗仁国　张　柳　段军伟　彭　华　赵　龙
637000 四川南充，川北医学院附属医院神经外科（李　舜、唐晓平、罗仁国、段军伟、彭　华、赵　龙）；510630 广东广州，暨南大学附属第一医院神经外科（文　军、张　柳）
Author(s):
LI Shun1;  TANG Xiao-ping1;  WEN Jun2;  LUO Ren-guo1;  ZHANG Liu2;  DUAN Jun-wei1;  PENG Hua1;  ZHAO long1.
1. Department of Neurosurgery, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China;
2. Department of Neurosurgery, The First Affiliated Hospital, Ji’nan University, Guangzhou 510630, China
关键词:
烟雾病; 动脉瘤; 颅内出血; 动脉瘤夹闭术; 颞浅动脉-大脑中动脉分流术; 成人
Keywords:
Moyamoya disease;  Intracranial hemorrhage;  Intracranial aneurysm;  Clipping;  Endovascular embolization;  Superficial temporal artery-middle cerebral artery bypass
分类号:
R 743.9; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.04.002
文献标志码:
A
摘要:
目的 探讨成人出血型烟雾病合并颅内动脉瘤的治疗方法。方法 回顾性分析2010年7月至2015 年3月收治的63例成人出血型烟雾病的临床资料，其中合并颅内动脉瘤8例。结果 63例中，蛛网膜下腔出血22例，伴发动脉瘤4例；脑室内出血35例，伴发动脉瘤4例；其他类型颅内出血6例，未发现颅内动脉瘤。8例伴发动脉瘤中，5例为主要动脉型动脉瘤，3例为外周动脉型动脉瘤；1例行开颅动脉瘤夹闭术+颞浅动脉-大脑中动脉（STA-MCA）分流术，5例行栓塞术+STA-MCA分流术，2例行保守治疗。所有病例出院后随访12~40个月，平均24个月；开颅夹闭+分流术或栓塞+分流术治疗的病人有较好疗效，无死亡及残疾，无再出血；2例保守治疗病人分别于初次发病后第11天、第20个月再出血死亡。结论 对成人出血型烟雾病合并动脉瘤，可行开颅夹闭或栓塞处理动脉瘤，再行STA-MCA分流术，预后较好；若为外周动脉型动脉瘤，不能栓塞可予保守治疗，但疗效不确切，可再发颅内出血。
Abstract:
Objective To investigate the clinical characteristics and strategies of the diagnosis and treatment of intracranial aneurysms in the adults with hemorrhagic moyamoya disease (HMMD). Methods The clinical data of 63 patients with HMMD treated from July, 2010 to March, 2015, of whom, 8 suffered from intracranial aneurysms and 55 not, were analyzed retrospectively. Results The aneurysms located at distal to Willis circles in 3 patients and at Willis circles in 5. Of 8 patients with intracranial aneurysms, 5 were treated by endovascularly embolization combined with superficial temporal artery-middle cerebral artery (STA-MCA) bypass, 1 by clipping intracranial aneurysm combined with STA-MCA bypass, and 2 conservatively. The curative effect was good in 6 patients undergoing the surgery and endovascular embolization. Other two patients who were conservatively treated died of intracranial rebleeding respectively 11 and 60 days after the first intracranial bleeding. Conclusions The curative effects of endovascular embolization and clipping on the intracranial aneurysms are good in the adults with HMMD. The prognosis is poor in the adults with intracranial aneurysms associated with HMMD only receiving the conservative treatment.

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备注/Memo

备注/Memo:
基金项目：四川省科技厅科研项目（2015SZ0114 )；四川省南充市科技局项目（14A0040）
通讯作者：唐晓平，E-mail：morelee@163.com
更新日期/Last Update: 2017-04-25