颅内外动脉搭桥术治疗复杂大脑中动脉瘤的临床效果研究  

Clinical Effect of Intracranial and External Artery Bypass Grafting in the Treatment of Complex Middle Cerebral Aneurysms

作　　者：于立刚[1] 崔恩东 许振东[1] 张维杰 李鹏林 YU Li-gang;CUI En-dong;XU Zhen-dong(Pingdu People’s Hospital,Shandong province,Qingdao 266700)

机构地区：[1]山东省平度市人民医院神经外科,山东青岛266700

出　　处：《医学临床研究》2020年第8期1171-1173,共3页Journal of Clinical Research

摘　　要：【目的】探讨颅内外动脉搭桥术治疗复杂大脑中动脉瘤的效果。【方法】回顾性分析2014年1月至2018年1月本院收治的22例复杂大脑中动脉瘤患者的临床资料,均给予IC-EC动脉搭桥术,采用mRS评分评估患者预后,采用日常生活量表(ADL)评估患者生活能力。DSA检查明确血管重建后的通畅情况,包括局部脑血流量(rCBF)、局部脑血容量(rCBV)、相对达峰时间(rTTP)、相对平均通过时间(rMTT)。【结果】所有患者术后1-2周复查DSA,显示载瘤动脉闭塞完全,血流通畅,无死亡病例。术后7d、术后3个月mRS评分明显较术前降低,而ADL评分明显较术前升高,差异均有统计学意义(P<0.05);术后3个月mRS评分明显低于术后7d,而ADL评分明显高于术后7d,差异均有统计学意义(P<0.05)。术后7d、术后3个月rCBF、rCBV明显高于术前,而rMTT、rTTP明显低于术前,差异均有统计学意义(P<0.05);术后3个月rCBF、rCBV明显高于术后7d,而rMTT、rTTP明显低于术后7d,差异均有统计学意义(P<0.05)。【结论】IC-EC动脉搭桥术治疗MCA动脉瘤有较好的效果,值得临床使用。【Objective】To investigate the effect of extracranial and intra arterial(IC-EC)artery bypass grafting in the treatment of complex middle cerebral artery aneurysms.【Methods】The clinical data of 22 patients with complex middle cerebral aneurysms treated in our hospital from January 2014 to January 2018 were retrospectively analyzed.IC-EC artery bypass grafting was performed.The prognosis of patients was evaluated by mRS score,and the living ability of patients was evaluated by daily living scale(ADL).DSA examination confirmed the patency after vascular reconstruction,including regional cerebral blood volume(rCBV),relative time to peak(RTTP),relative mean transit time(rMTT).【Results】DSA was reexamined in all patients 1-2 weeks after operation.The results showed that the parent artery was completely occluded,the blood flow was unobstructed,and there was no death case.The mRS score at 7 days and 3 months after operation was significantly lower than that before operation,while the ADL score was significantly higher than that before operation(P<0.05);the mRS score of 3 months after operation was significantly lower than that of 7 days after operation,and the ADL score was significantly higher than that of 7 days after operation,the differences were statistically significant(P<0.05).The rCBV of 7 days and 3 months after operation was significantly higher than that before operation,while rMTT and rTTP were significantly lower than those before operation(P<0.05);rCBV of 3 months after operation was significantly higher than that of 7 days after operation,while rmtt and rTTP were significantly lower than 7 days after operation,the differences were statistically significant(P<0.05).【Conclusion】IC-EC artery bypass grafting has a good effect in the treatment of MCA aneurysms,which is worthy of clinical use.

关 键 词：颅内动脉瘤/外科学 大脑中动脉 

分 类 号：R743.9[医药卫生—神经病学与精神病学]