颞浅动脉-颞前动脉搭桥联合脑-硬膜-肌肉血管融合术治疗烟雾病的临床疗效分析  

Efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephaloduro-arterio-synangiosis in treatment of moyamoya disease

作　　者：宋仁兴[1] 庞春晓 王丽娜 王增武[1] 谢昆明 李义飞 陈乐美 郭晖[1] Song Renxing;Pang Chunxiao;Wang Lina;Wang Zengwu;Xie Kunming;Li Yifei;Chen Lemei;Guo Hui(Department of Neurosurgery,Weifang People's Hospital,Weifang 261041.China;Department of Neurosurgery,Binhai Branch,Weifang People's Hospital,Wifang 262737,China)

机构地区：[1]潍坊市人民医院神经外科,261041 [2]潍坊市人民医院滨海分院神经外科,262737

出　　处：《中华神经医学杂志》2020年第8期805-809,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨题浅动脉-颗前动脉搭桥联合脑-硬膜-肌肉血管融合术治疗烟雾病的临床疗效。方法潍坊市人民医院神经外科自2016年1月至2019年1月采用题浅动脉-大脑中动脉搭桥联合脑-硬膜-肌肉血管融合术治疗烟雾病患者42例,其中搭桥受体血管为角回动脉者12例(颞浅动脉-角回动脉搭桥组).搭桥受体血管为题前动脉者30例(颞浅动脉-题前动脉搭桥组)。回顾性收集2组患者的临床资料并比较其临床疗效安全性的差异。结果2组患者的手术时间比较[(189.16±21.23)min vs.(179.46±16.95)min]差异无统计学意义(P>0.05)。术后1d,2组患者复查颅脑CT血管成像示吻合血管均通畅。颞浅动脉-颗前动脉搭桥组发生术区脑梗死2例.题浅动脉-角回动脉搭桥组发生术区脑梗死1例.2组间并发症发生率差异无统计学意义(P>0.05)。与术前1d比较,术后1个月2组患者的改良Rankin量表(mRS)评分均明显降低,且颇浅动脉-题前动脉搭桥组患者的mRS评分[(0.13±0.115)分]明显低于颞浅动脉-角回动脉搭桥组[(0.42±0.251)分],差异均有统计学意义(P<0.05)。结论颞浅动脉-题前动脉搭桥联合脑-硬膜-肌肉血管融合术治疗烟雾病具有确切的临床疗效。Objective To investigate the clinical fficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in the treatment of Moyamoya discase.Methods A total of 42 patients with moyamoya disease,admitted to our hospital from January 2016 to January 2019,were sclected and divided into observation group and control group according to surgical management.The patients in the observation group were treated with superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis,and the patients in the control group were treated with superficial temporal artery-angular gyrus artery bypass combined with encephalo-duroarterio-synangiosis.The clinical data of these patients were analyzed retrospectively,and the differences of efficacy and safety between the two groups were compared.Results There was no significant difference in operation time between the two groups([189.16±21.23]min vs.[179.46±16.95]min,P>0.05).One d after the operation,the patients in both groups were re-examined with CT angiography,and the anastomotic vessels were unobligated.Two patients in the observation group had cerebral infarction in the operative region and one patient in the control group had cercbral infarction in the operative region;no significant difference was noted in the incidence of postoperative complications between the two groups(P>0.05).The modified Rankin scale(mRS)scores in both groups one month after surgery were significantly decreased as compared with those one d before surgery(P<0.05);one month after surgery,the mRS scores in observation group(0.13±0.346)were significantly lower than those in the control group(0.42±0.515,P<0.05).Conclusion The superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis has definite clinical efficacy in the treatment of moyamoya disease.

关 键 词：烟雾病 颞浅动脉-颞前动脉搭桥 颞浅动脉-角回动脉搭桥 脑-硬膜-肌肉血管融合术 临床疗效 

分 类 号：R651.12[医药卫生—外科学]