颅内外血管搭桥与颞肌贴敷术联合对成人烟雾病的治疗效果观察  

Observation on the therapeutic effect of intracranial and extracranial vascular bypass and temporal muscle application on adult moyamoya disease

作　　者：谢兰军[1] 宁亮[1] 杨春春[1] XIE Lan-jun;NING Liang;YANG Chun-chun(Department of Military Sursery,Fuyang People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市人民医院神经外科,安徽阜阳236000

出　　处：《临床和实验医学杂志》2020年第13期1396-1399,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省高等学校自然科学研究支持项目(编号:KJ2015B088by)。

摘　　要：目的探讨颅内外血管搭桥与颞肌贴敷术联合对成人烟雾病的治疗效果。方法回顾性选取阜阳市人民医院2017年1月至2019年12月收治的烟雾病患者38例,按照治疗方法将其分为观察组和对照组,每组各19例。观察组患者采用颅内外搭桥+颞肌贴敷术治疗,对照组患者仅采用颞肌贴敷术治疗。比较两组患者的疗效、术前和术后改良rankin评分以及术后6个月脑血流量、脉压及血流峰值。结果观察组疗效显著的患者比率(65.00%)显著高于对照组(36.84%),总有效率(94.74%)显著高于对照组(68.42%),差异均具有统计学意义(P<0.05)。术前两组患者的改良rankin评分比较(2.83±0.56分vs.2.75±0.71分),差异无统计学意义(P>0.05);术后3个月观察组患者的改良rankin评分(1.21±0.22分)显著低于对照组(1.63±0.41分),差异具有统计学意义(P<0.05)。术后6个月观察组患者的脑血流量(12.52±2.12 mm/s)、脉压(34.21±14.54 mm Hg)及血流峰值(171.32±20.32 cm/s)均显著高于对照组(11.67±2.21 mm/s,26.33±11.43 mm Hg,150.61±19.02 cm/s),差异具有统计学意义(P<0.05)。结论颅内外血管搭桥联合颞肌贴敷术治疗成人烟雾病疗效好,有助于改善患者的神经功能和脑血流灌注。Objective To explore the therapeutic effect of the combination of intracranial and extravascular vascular bypass and temporal muscle application on adult moyamoya disease.Methods A total of 38 patients with moyamoya disease treated in Fuyang People’s Hospital from January 2017 to December 2019 were retrospectively selected and divided into observation group and control group according to the therapeutic methods There were 19 cases in each group,the observation group was treated with intracranial and external bypass+temporal muscle application,and the control group was treated with temporal muscle application only.The curative effect,preoperative and postoperative modified rankin scores,and cerebral blood flow,pulse pressure difference,and peak blood flow at 6 months were compared between the two groups.Results The proportion of patients with significant effect in the observation group(65.00%)was significantly higher than that in the control group(36.84%),and the total effective rate(94.74%)was significantly higher than that in the control group(68.42%),with differences statistically significant(P<0.05).There was no significant difference in the modified rankin(2.83±0.56 vs.2.75±0.71)score between the two groups of patients before surgery(P>0.05).The modified rankin score of the observation group(1.21±0.22)at 3 months after surgery was significantly lower than that of the control group(1.63±0.41),and the difference was statistically significant(P<0.05).The cerebral blood flow(12.52±2.12 mm/s),pulse pressure difference(34.21±14.54 mm Hg),and peak blood flow(171.32±20.32 cm/s)in the observation group at 6 months after operation were significantly higher than those in the control group(11.67±2.21 mm/s,26.33±11.43 mm Hg,150.61±19.02 cm/s),and the differences were statistically significant(P<0.05).Conclusion Intracranial and extravascular vascular bypass combined with temporal muscle application is effective in the treatment of moyamoya disease in adults,and it is helpful to improve the neurological functio

关 键 词：烟雾病 血管搭桥 颞肌贴敷 

分 类 号：R651.12[医药卫生—外科学]