综合术式治疗成年烟雾病的临床作用  

Comprehensive surgical treatment for adult Moyamoya disease

作　　者：宋国红[1] 卜凡儒[2] 王登芹[1] 刘军[2] 苏春海[2] 徐斌[3] 段德义[2] 

机构地区：[1]济宁医学院临床学院,山东济宁272000 [2]济宁市第一人民医院神经外科,山东济宁272000 [3]复旦大学附属华山医院神经外科,上海200040

出　　处：《中华神经外科疾病研究杂志》2012年第3期204-207,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：济宁医学院2008青年科学基金资助项目

摘　　要：目的探讨综合术式(即颞浅动脉-大脑中动脉分支吻合术结合脑-硬脑膜-肌肉血管融合术)在治疗成年烟雾病中的效果。方法 37例成年烟雾病中,出血首发者9例,缺血首发者28例,均接收综合术式的治疗,其中18例接收双侧手术,12例接收同侧两支吻合。结果经该手术治疗后,手术侧血流均有立即改善,缺血症状迅速缓解,随访效果好。手术并发症1例,在吻合区附近出现小梗塞灶。结论本手术方式是将颞浅动脉用作与大脑中动脉分支直接吻合的血管供体,同时又将硬脑膜(脑膜中动脉)、颞肌(颞深动脉)用作血管融合术的血管供体,故综合术式是治疗成年烟雾病患者有效而合理的选择方法。Objective To study the therapeutic effect of superficial temporal artery middle cerebral artery （STA-MCA） anastomosis combining with original encephaloduromyosynangiosis in adults with Moyamoya disease. Methods A total of 37 cases of Moyamoya disease, including 28 cases of ischemic type and 9 cases of hemorrhagic type, were performed direct STA-MCA bypasses combining with encephaloduromyosynangiosis. Results The cerebral blood flow was increased immediately after operation. The ischemic symptoms were relieved in all the patients. No rebleeding was found in follow-up. Operation related small infarction was observed 1 case. Conclusion Indirect revascularization makes temporal muscle （the deep temporal artery） and the dura mater （the middle meningeal artery） as ＂encephaloduromyosynangiosis （EDMS） ＂. The combination of STA-MCA bypass with EDMS is a rational approach for the treatment of adult Moyamoya disease.

关 键 词：烟雾病 吻合术 脑血管重建 

分 类 号：R743.3[医药卫生—神经病学与精神病学]