多普勒超声血流动力学监测在烟雾病STA-MCA吻合术中的应用  

Change in the STA hymodynamics monitored by color Doppler ultrasound before and after STA-MCA anastomosis in patients with Moyamoya disease

作　　者：杨允东 李永强 YANG Yun-dong;LI Yong-qiang(Department of Neurosurgery,Qingzhou Municipal People's Hospital,Qingzhou 262500,China)

机构地区：[1]青州市人民医院神经外科,山东262500

出　　处：《中国临床神经外科杂志》2018年第7期476-478,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨多普勒超声血流动力学监测在评定烟雾病STA-MCA吻合术后疗效中的价值。方法回顾性分析22例行STA-MCA吻合术治疗的烟雾病的临床资料。术前、术后3个月进行STA多普勒频超声检查,并测量收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、平均血流速度(Vm),计算搏动指数(PI)=(PSV-EDV)/Vm,阻力指数(RI)=(PSV-EDV)/PSV;并与DSA分级结果进行对比。结果 22例共进行40侧STA-MCA吻合术,术后复查DSA显示,分级良好为33侧(82.5%),分级不良为7侧(27.5%)。DSA分级供血良好组术后STA血流速度明显高于术前,以EDV和Vm增幅最大(P<0.05),而PI明显低于不良组(P<0.01)。DSA分级为不良组术后STA血流速度明显低于术前,以PSV和PI显著降低(P<0.05),EDV、Vm和RI无显著变化。术前与术后EDV比值(rs=0.453;P<0.001)、术后PI(rs=0.512;P<0.001)与术后DSA分级显著相关。结论多普勒超声检测STA-MCA吻合术后STA的血流变化,与DSA有较好的一致性,可以作为一个间接观察烟雾病STA-MCA吻合术后脑供血改善程度的指标。Objective To explore the value of the change in the superficial temporal artery(STA)hemodynamics monitored by color Doppler ultrasound to the evaluation of the curative effect of STA-middle cerebral artery(MCA)anastomosis on moyamoya disease.Methods The changes in the STA hemodynamics were monitored by color Doppler ultrasound in the 22 patients with moyamoya disease before and 3 months after STA-MCA bypass surgery.The outcomes of STA hemodynamics determined by color Doppler ultrasound were compared with outcomes of DSA 3 months after the surgery.Results DSA 3 months after the surgery showed that there was good supply of blood for brain tissues in 18 patients(good group)and poor in 4(poor group).The values of end-diastolic blood flow velocity(EDV)and mean velocity(Vm)of STA were significantly higher and pulse index(PI)of STA was significantly lower in the good group than those in the poor group 3 months after the surgery(P<0.05).The values of peak systolic velocity and PI of STA decreased significantly after surgery compared to the preoperation in the poor group(P<0.05).Conclusions The changes in STA blood flow detected by color Doppler ultrasound were consistent with the outcomes detected by DSA after STA-MCA anastomosis and can be used as an indirect indicator of the degree of improvement of cerebral blood flow after STA-MCA anastomosis in the patients with moyamoya disease.

关 键 词：烟雾病 颞浅动脉-大脑中动脉吻合术 多普勒超声 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]