联合血管重建术治疗烟雾病疗效评价  

Evaluation of the clinical effect of combined revascularization on moyamoya disease treatment

作　　者：陈波[1] 李冬梅 杜世伟[2] 徐祎[2] 王成俊[2] 毛更生[2] 

机构地区：[1]徐州医学院研究生院,221004 [2]武警总医院神经血管外科

出　　处：《神经疾病与精神卫生》2014年第1期24-27,共4页Journal of Neuroscience and Mental Health

摘　　要：目的 探讨联合血管重建术治疗烟雾病的疗效.方法 23例缺血型烟雾病患者均采用颞浅动脉-大脑中动脉分支吻合与脑-硬膜-肌肉血管融合术（STA-MCA＋ EDMS）手术方法.术前、术后1周及术后3个月行mRS评分,并测量术前、术后1周手术侧大脑中动脉分布区的CT灌注参数.结果 22例患者术后1周行DSA或CTA检查示吻合口通畅,1例吻合血管闭塞.术后3个月mRS评分与术前、术后1周两组比较,差异有统计学意义（P＜0.05）.所有患者手术侧大脑中动脉分布区CT灌注成像各参数分别行分析,结果显示：术后1周示CBF增加,MTT、TTP缩短,与术前比较差异有统计学意义（P＜0.05）.结论 联合血管重建术能改善缺血型烟雾病患者症状.Objective To explore the curative effect of the combined revascularization on moyamoya disease.Methods Totals of 23 cases of ischemic moyamoya disease patients were treated by using superficial temporal artery-middle cerebral artery anastomosis combining with encephaloduromyosynangiosis （STA-MCA＋EDMS）.Evaluated by mRS （Modified Rankin Scale） score before the operation,one week and three months after the operation.The patients were evaluated before surgery,one week after surgical on CT perfusion parameters from the middle cerebral artery.Results There were 22 patients adopted DSA or CTA examination revealed anastomotic patency at week one and one patient showed occlusive vascular anastomosis.The outcomes of mRS showed that the neurological function was better three months after the surgery than that before and one week after the surgery in the patients with moyamoya disease （P＜ 0.05）.All patients were evaluated with CT perfusion imaging on the side of the middle cerebral artery surgery.Each parameter showed as CBF increased,MTT and TTP shortened （P ＜0.05）,and CBV without change （P＞ 0.05）.Conclusions Combined revascularization could improve the symptoms of ischemic moyamoya disease patients.

关 键 词：烟雾病 CT灌注 血管重建术 

分 类 号：R654.3[医药卫生—外科学]