| BackgroundMoyamoya disease,also known as spontaneous skull base artery occlusion or spontaneous occlusion of the circle of willis,is a kind of angiogenic cerebrovascular disease which mostly occurs in Asian countries,especially in Japan,China and Korea.With the knowledge of this kind of disease becomes richer and richer,and with the development of medical imaging equipment and technology,the morbidity of moyamoya disease becomes higher and higher all over the world.Moyamoya syndrome is almost all the same in imagine findings and clinical manifestations compared with moyamoya disease,and the desperation of these two diseases mainly depends on exclusion of tens of other kinds of other disease,which means not so much in clinic and will cause huge burden to patients,so Shandong university Qilu hospital doesn’t desperate them strictly.In this research,we discuss these two diseases together.The treatment of moyamoya disease and moyamoya syndrome mainly depends on drugs and operations.At present,revascularization remains the most effective treatment all over the world.Though the operation technology is becoming more and more mature,ameliorative rate of symptom is becoming higher and higher,but the postoperative complications can be seen now and then,which will cause huge burden to both patients and medical workers.The precaution and treatment of postoperative complications strict.ObjectiveTo discuss the risk factors of the postoperative complications of revascularization,hoping to deduce the probability of occurrence of the postoperative complications.MethodsTo summarize the 141 cases with moyamoya disease or moyamoya syndrome who went through revascularization in department of Neurosurgery,Shandong University Qilu Hospital from January 1,2015 to December 31,2016,to collect their clinical features,including enumeration data such as the gender,concomitant diseases(including hypertension and diabetes mellitus),disease type(ischemic-type or hemorrhagic-type),operation type(direct revascularization or combined revascularization);measurement data such as age,level of blood sugar,level of blood lipid(including cholesterol level,triglyceride level,high-density lipoprotein level,low-density lipoprotein level),unit interval input and output,blood pressure level(average value of preoperative and during-operative blood pressure),operation time and time of artery occlusion.Classify the cases due to whether had postoperative complications or not.We analyzed the possible factors of postoperative complications after revascularization in moyamoya disease or moyamoya syndrome with SPSS 23.0.To enumeration data,we use chi-square test.To measurement data,we use two independent sample t-test.After finding out the positive result,we use logistic regression model to find out whether it’s the independent risk factor of certain postoperative complication.In corporation with some references,we discussed some risk factors toward certain postoperative complications such as new-found cerebral infarction,hyperperfusion cerebral hemorrhage,epileptic seizure,undesirable healing,and so on.Furthermore,we also discussed some risk factors toward hyperperfusion syndrome.By doing so,we are hoping to deduce the probability of occurrence of the postoperative complications.ResultsThe trial included 135 patients(141 cases)with moyamoya disease or moyamoya syndrome who went through revascularization in department of Neurosurgery,Shandong University Qilu Hospital,in which 129 patients went through revascularization on one side,6 patients went through revascularization on both sides.There were 62 male cases and 79 female cases,aging from 18 to 64.The mean age of patients was.43.20±9.16.There were 73 cases went through direct revascularization,68cases went through combined revascularization.There were 54 cases combined with hypertension,29 cases combined with diabetes mellitus,in which 16 cases combined both.As for the postoperative complications,the total rate was 12.0%,with new-found cerebral infarction 9 cases(6.4%),hyperperfusion cerebral hemorrhage 2 cases(1.4%),epileptic seizure 2 cases(1.4%),undesirable healing 5cases(3.5%),in which lease combined with both epileptic seizure and undesirable healing.We also found 15(10.6%)cases with hyperperfusion syndrome.Conclusions1.The independent risk factor of new-found cerebral infarction are age,time of artery occlusion and preoperative blood pressure.The high-density lipoprotein level is the dependent protective factor.2.The independent risk factor of undesirable healing is the blood sugar level.3.The independent risk factor of hyperperfusion syndrome are time of artery occlusion and unit interval input. |
