颞肌贴敷与颅内外血管搭桥联合治疗烟雾病疗效观察  

Effect of temporalis muscle flap combined with extracranial-intracranial vascular bypass in the treatment of moyamoya disease

作　　者：李琛[1] 曹旭华[1] 马志昭[1] 张皓峰[1] 胡福广[1] 王立群[1] 孙晓枫[1] 

机构地区：[1]河北医科大学第二医院神经外科,河北石家庄050000

出　　处：《海南医学》2017年第22期3734-3735,共2页Hainan Medical Journal

摘　　要：目的探讨颞肌贴敷与颅内外血管搭桥联合治疗烟雾病的临床疗效。方法选择河北医科大学第二医院神经外科2012年1月至2017年1月期间治疗的32例烟雾病患者为研究对象,根据随机数表法分为观察组与对照组,每组16例,对照组患者进行脑-硬脑膜-颞浅动脉贴敷术治疗,观察组患者采用颞肌贴敷和颞浅动脉-大脑中动脉搭桥联合治疗,比较两组患者治疗后改良m RS评分的变化,并比较大脑中动脉平均血流速度(Vm)和搏动指数(PI)。结果治疗后3个月,观察组患者的改良m RS评分为(1.28±0.48)分,明显低于对照组的(1.67±0.57)分,差异有统计学意义(P<0.05);观察组患者的Vm、PI分别为(72.25±12.14)cm/s、(0.50±0.18),与对照组的(63.47±11.97)cm/s、(0.68±0.23)比较差异均有统计学意义(P<0.05)。结论颞肌贴敷和颞浅动脉-大脑中动脉搭桥联合治疗烟雾病具有确切的临床疗效。Objective To investigate the clinical effect of temporalis muscle flap combined with extracranialintracranial vascular bypass in the treatment of moyamoya disease. Methods A total of 32 cases of patients with moyamoya disease, who admitted to Department of Neurosurgery of the Second Hospital of Hebei Medical University from January 2012 to January 2017, were selected and divided into the observation group and the control group according to random number table method, with 16 cases in each group. The control group was treated with encephaloduromy superficial temporal artery sticking treatment, and the observation group were treated with temporalis muscle flap combined with superficial temporal artery to middle cerebral artery（STA-MCA） bypass. After the treatment, the modified m RS scores, brain artery mean blood flow velocity（Vm）, pulsatility index（PI） were compared between the two groups. Results After the treatment of three months, the modified m RS score in observation group was（1.28 ± 0.48）,which was significantly lower than（1.67±0.57） in the control group（P0.05）; the Vm and PI were respectively（72.25±12.14） cm/s and（0.50±0.18） in observation group versus（63.47±11.97） cm/s and（0.68±0.23） in the control group（P0.05）. Conclusion The application of temporalis muscle flap combined with STA-MCA bypass has definite clinical efficacy in the treatment of moyamoya disease.

关 键 词：烟雾病 颞肌贴敷 颅内外血管搭桥 疗效 

分 类 号：R743[医药卫生—神经病学与精神病学]