摘要
目的研究颞浅动脉-大脑中动脉搭桥术(STA-MCA bypass)+脑-硬膜-颞浅动脉贴敷术治疗烟雾病(MMD)的效果。方法选取2021年9月至2023年6月绵阳市中心医院和四川大学华西医院收治的103例MMD患者,其中51例采用STA-MCA bypass+脑-硬膜-颞浅动脉贴敷术的患者为颞浅动脉组,52例采用STA-MCA bypass+脑-颞肌贴敷术的患者为颞肌组。比较两组围手术期指标、搭桥血管通畅情况与松岛分级、脑血流灌注、并发症、改良Rankin量表(mRS)评分。结果颞浅动脉组术中出血量低于颞肌组,手术时间、住院时间短于颞肌组(P<0.05);两组术后3个月搭桥血管通畅率及松岛分级比较差异无统计学意义(P>0.05);颞浅动脉组术后3个月平均通过时间(MTT)、脑血流量(CBF)、峰值时间(TTP)、脑血容量(CBV)与颞肌组比较差异无统计学意义(P>0.05);颞浅动脉组脑出血、癫痫、高灌注综合征、脑梗死、硬膜下积液总发生率低于颞肌组(P<0.05);颞浅动脉组术前、出院时、术后3个月mRS评分与颞肌组比较差异无统计学意义(P>0.05)。结论STA-MCA bypass+脑-硬膜-颞浅动脉贴敷术治疗MMD创伤小、术后恢复快,能获得满意的血管通畅率和功能预后,且并发症发生率低。
Objective To study the effect of superficial temporal arterion-middle cerebral artery bypass(STA-MCA bypass)+brain-dural arterion-superficial temporal artery application in the treatment of moyamoya disease(MMD).Methods A total of 103 patients with MMD treated in Mianyang Central Hospital and West China Hospital of Sichuan University from September 2021 to June 2023 were selected.Among them,51 patients receiving STA-MCA bypass+brain-dural superficial temporal artery application were selected as the superficial temporal artery group,and 52 patients receiving STA-MCA bypass+brain-temporal muscle application were selected as the temporal muscle group.Perioperative indexes,bypass artery patency,Matsushima scale,cerebral blood perfusion,complications and modified Rankin scale(mRS)score were compared between the two groups.Results The amount of blood loss in the superficial temporal artery group was lower than that in the temporal muscle group,and the operation time and hospital stay were shorter than that in the temporal muscle group(P<0.05).There were no differences in the patency rate and Matsushima grade of bypass vessels 3 months after operation between the two groups(P>0.05).There was no significant difference in mean transit time(MTT),cerebral blood flow(CBF),time to peak(TTP),and cerebral blood volume(CBV)between the superficial temporal artery group and the temporal muscle group 3 months after surgery(P>0.05).The total incidence of cerebral hemorrhage,epilepsy,hyperperfusion syndrome,cerebral infarction and subdural effusion in superficial temporal artery group was lower than that in temporal muscle group(P<0.05).There was no difference in mRS Scores between superficial temporal artery group and temporal muscle group before surgery,at discharge and 3 months after surgery(P>0.05).Conclusion STA-MCA bypass+brain-dural superficial temporal artery application in the treatment of MMD has less trauma,faster postoperative recovery,satisfactory vascular patency rate and functional prognosis,and low incidence of complications.
作者
曾辉
李宗平
何鹏臣
张恒
Zeng Hui;Li Zongping;He Pengchen;Zhang Heng(Department of Neurosurgery,the Mianyang Central Hospital,Mianyang Hospital,University of Electronic Science and Technology,Sichuan 621000,China)
出处
《脑与神经疾病杂志》
2025年第7期423-427,共5页
Journal of Brain and Nervous Diseases
基金
绵阳市卫健委2021年科研课题(202103)
2020年四川省医学(青年创新)科研课题(S20224)。
作者简介
通信作者:李宗平,Email:jing_zp@sina.com。
