颞浅动脉-大脑中动脉搭桥术治疗大脑中动脉狭窄或闭塞16例疗效分析  

STA-MCA Bypass Grafting in the Treatment of Middle Cerebral Artery Stenosis or Occlusion in 16 Patients

作　　者：孙剑[1] 李冬梅 高天[1] 杜世伟[1] 刘春晖[1] 毛更生[1] 

机构地区：[1]武警总医院神经血管外科,北京100039

出　　处：《神经损伤与功能重建》2012年第4期278-281,共4页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨颞浅动脉-大脑中动脉(STA-MCA)搭桥术治疗伴大脑中动脉狭窄或闭塞的缺血性卒中患者的效果。方法:伴大脑中动脉狭窄或闭塞的缺血性卒中患者16例,行STA-MCA搭桥术或STA-MCA搭桥术联合脑-硬脑膜-动脉贴敷(EDAS);术中采用脑血管吲哚菁绿荧光造影、术后行血管超声以确定吻合血管通畅情况;术前、术后1周及出院3个月后采用改良Rankin量表(mRS)对患者进行神经功能评分,随访3个月。结果:所有病例手术均顺利完成;吻合口处血流通畅者15例(93.75%),血流缓慢者1例(6.25%);无患者再发缺血性卒中;术前1周、术后1周及3个月mRS评分良好的患者分别为6例(37.50%)、7例(43.75%)、14例(87.50%);3月时mRS评分良好的患者例数高于术前和术后1周者(P=0.0091,P=0.0233)。结论:STA-MCA搭桥术或联合EDAS治疗大脑中动脉狭窄或闭塞所致脑组织的低灌注效果满意。Objective： To evaluate the therapy efficacy of superficial temporal artery-middle cerebral artery （STA-MCA） bypass grafting treatment for ischemic stroke patients with severe middle cerebral artery stenosis or occlusion. Methods： A total of 16 patients with ischemic strokes due to severe middle cerebral artery stenosis or occlusion were treated with STA-MCA bypass grafting or combined with encephalo-duro-arterio-synangiosis （EDAS）. Revascularization was evaluated using indocyanine green fluorescence angiography and vascular ultrasound. All pa- tients were follow-up for 3 months. Modified Rankin scale （mRS） was used to evaluate the neu- rologic function of the patients at 1 week before, 1 week and 3 months after the treatment. Re sults： All operations were successfully performed on the patients. Velocity of blood flow in 15 patients （93.75%） was normal, while slow velocity of blood flow was found only in one patient （6.25%）. There was no documentation of recurrence of ischemic strokes in 3 months follow-up. According to the scores of mRS, the number of patient with good outcome at 1 week before, 1 week and 3 months after the treatment was 6 （37.50%）, 7 （43.75%） and 14 （87. 50^） respectively. The number of patients with good outcome at 3 months after the treatment was signifi- cantly higher than those at 1 week before and after treatment （P=0. 0091,P=0. 0233）. Conclu- sion. STA-MCA bypass grafting or STA-MCA bypass grafting combined with EDAS is effective for ischemic stroke due to severe middle cerebral artery stenosis or occlusion.

关 键 词：血管狭窄 缺血性卒中 颞浅动脉-大脑中动脉搭桥术 吲哚菁绿荧光造影术 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]