颞浅动脉-大脑中动脉搭桥术在治疗大脑中动脉闭塞缺血性脑血管病的疗效分析  

Observation on the curative effect of superficial temporal artery-middle cerebral artery bypass in the treatment of ischemic cerebrovascular disease caused by middle cerebral artery occlusion

作　　者：辛晓东 郝万如 郭云 王小刚[2] 吴勇强[2] 张文举 XIN Xiaodong;HAO Wanru;GUO Yun;WANG Xiaogang;WU Yongqiang;ZHANG Wenju(The First People's Hospital of Yuanping,Yuanping 034100,China;The First Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]原平市第一人民医院,山西原平034100 [2]山西医科大学第一医院,山西太原030000

出　　处：《临床医药实践》2023年第9期665-668,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨颞浅动脉-大脑中动脉(STA-MCA)搭桥术在治疗大脑中动脉闭塞所致的缺血性脑卒中患者的临床疗效。方法:回顾性分析25例大脑中动脉闭塞的缺血性脑卒中患者的临床资料。所有患者均采用了STA-MCA搭桥术。通过手术前、后脑血管造影及CT脑灌注成像对吻合口通畅情况及脑血流动力学进行评估。术后对患者进行长期随访,观察相关并发症及有无再发卒中。应用改良Rankin量表(mRS)对患者术后6个月的神经功能进行评估。结果:所有病例均顺利完成了手术;25例患者无一例出现相关并发症。术后造影示吻合口通畅,CT血流灌注成像显示术后6个月患侧脑血流量(rCBF)明显增加(P<0.05),脑血流平均通过时间(rMTT)下降明显(P<0.05)。神经功能mRS评分在术后6个月较术前有明显下降。结论:STA-MCA搭桥术可以提高闭塞侧脑组织的血流量,改善神经功能并降低缺血性脑卒中的发生风险。Objective:To investigate the clinical efficacy of superficial temporal artery-middle cerebral artery(STA-MCA)bypass in the treatment of ischemic stroke caused by middle cerebral artery occlusion.Methods:Twenty-five ischemic stroke patients with middle cerebral artery occlusion underwent STA-MCA bypass.The patency of anastomosis and cerebral hemodynamics were evaluated by cerebral angiography and CT perfusion imaging before and after operation.The patients were followed up for 6 months after surgery to observe the related complications and recurrent stroke.The modified Rankin scale(mRS)was used to evaluate the neurological function of the patients before and after surgery.Results:All operations were successfully completed.None of the 25 patients had related complications.Postoperative angiography showed that the anastomosis was unblocked.CT perfusion imaging showed that the relative cerebral blood flow(rCBF)of the affected side increased significantly at 6 months after operation(P<0.05),and the relative mean transmit time(rMTT)were significantly decreased(P<0.05).The mRS score of neurological function at 6 months after operation was significantly lower than that before operation.Conclusion:STA-MCA bypass can improve the cerebral blood flow of the diseased side,improve neurological function and reduce the risk of ipsilateral stroke.

关 键 词：大脑中动脉闭塞 缺血性脑卒中 颞浅动脉-大脑中动脉搭桥术 

分 类 号：R742[医药卫生—神经病学与精神病学]