兒童單側(cè)出血型煙霧病腦血運重建術(shù)的中長期 療效及預(yù)后分析

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【中圖分類號】R743；R651 【文獻標志碼】A 【文章編號】1672-7770（2025）02-0121-05

Abstract： Objective To explore the medium-andlong-term curative effects after cerebrovascular revascularization for children with unilateral hemorrhagic moyamoya disease （MMD）. Methods The clinical data of 13 pediatric patients with unilateral hemorrhagic MMD who underwent treatment at Beijing Tiantan Hospital from October 2010 to February 2025 were analyzed retrospectively. Among them， 1l received combined superficial temporal artery-middle cerebral artery（ STA-MCA） bypass with encephalo-duro-arterio-synangiosis（ EDAS），1 underwent EDAS alone， and 1 was treated conservatively. Follow-up endpoints included rebleeding， cerebral infarction， and death. ResultsAmong 13 children， intraventricular hemorrhage predominated in 4 cases （38.5% ）. During a median follow-up of 93 months（IQR 51 -133）， rebleeding occurred in 1 patient （7.7%） at 29 months post-EDAS surgery. Additionally， 1 patient（ 7.7% ）experienced a transient ischemic attack （ TIA） 2 months after combined revascularization， followed by a new cerebral infarction at 7 months postoperatively. No mortality or contralateral progression was observed on follow-up computed tomography angiography（CTA）. Favorable neurological outcomes （modified Rankin Scale score ？2 ）were achieved in 84.6%（11/13）of cases. Conclusions Unilateral hemorrhagic MMD in pediatric patients shows a low risk of contralateral progression during medium-and long-term follow-up.Combined cerebral revascularization effectively mitigates rebleeding risk and ensures favorable neurological outcomes， highlighting its safety and efficacy in pediatric populations.

Key words： moyamoya disease； cerebrovascular revascularization； child； neurological prognosis； follow-up study

煙霧?。╩oyamoyadisease，MMD）是一種以顱內(nèi)動脈末端慢性進行性狹窄/閉塞伴代償性煙霧狀血管網(wǎng)形成為特征的腦血管疾病，其病因尚未完全闡明，可能與遺傳（如RNF213基因突變）、免疫異?；颦h(huán)境因素相關(guān)[1-3]。（剩余8276字）