高流量搭桥手术在头颈复杂病变中的应用及疗效观察  

Application and therapeutic observation of high flow bypass surgery in complex head and neck lesions

作　　者：袁国艳 杨光华 吴平安 张作洪 张振宇 何伟成 任铭新 YUAN Guo-yan;YANG Guang-hua;WU Ping-an;REN Ming-xin(Department of Neurosurgery,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518000,China;不详)

机构地区：[1]香港大学深圳医院神经外科,深圳518000 [2]香港大学深圳医院头颈外科,深圳518000 [3]南方科技大学医学院

出　　处：《临床神经外科杂志》2023年第1期84-88,共5页Journal of Clinical Neurosurgery

基　　金：香港大学深圳医院科研培育计划青年项目(HKUSZH201901041)。

摘　　要：目的 探讨高流量搭桥手术在头颈复杂病变中的应用及疗效观察。方法 回顾性分析2016年3月—2021年2月香港大学深圳医院收治的10例颅底复杂病变患者的临床资料,术中应用高流量颅内外搭桥进行血管重建,对患者的术前评估、诊疗经过及术后随访情况进行分析。结果 10例患者均成功实施颅内外高流量搭桥手术,术中吲哚菁绿荧光造影显示搭桥血管通畅。术后并发症颅内出血2例,颅内感染2例,脑积水2例,脑卒中1例,术后3个月改良Rankin量表评分0~3分9例,4分1例。结论 头颈部复杂病变累及颈内动脉的情况下,应用高流量颅内外血管搭桥手术是一种有效的治疗方法。术前评估脑组织供血状态、选用合适的搭桥血管和吻合方式是治疗方案的关键。Objective To investigate the application and therapeutic observation of high flow bypass surgery in complex head and neck lesions. Methods The clinical data of 10 patients with complex head and neck lesions admitted to the University of Hong Kong-Shenzhen Hospital from March 2016 to February 2021 were analyzed retrospectively. During the operation, high flow extracranial bypass was used for vascular reconstruction, and the preoperative evaluation, diagnosis and treatment process and postoperative follow-up were analyzed. Results Intracranial and extracranial high flow bypass surgery was successfully performed in all 10 patients. Indocyanine green fluorescence angiography showed patency of bypass vessels during operation. Postoperative complications included intracranial hemorrhage in 2 cases, intracranial infection in 2, hydrocephalus in 2 and infarction in 1. After 3 months of operation, the modified Rankin scale scored 0-3 points in 9 and 4 points in 1. Conclusions High flow intracranial to extracranial bypass surgery is a safe and effective method for complex head and neck lesions. Preoperative evaluation of brain blood supply, selection of appropriate bypass vessels and anastomosis are the key to treatment.

关 键 词：颅内外血管搭桥术 高流量 头颈部复杂病变 

分 类 号：R651.11[医药卫生—外科学]