北京大学学报（医学版）2013，Vol.45Issue(1)：123-128,6.DOI:10.3969/j.issn.1671-167X.2013.01.026
颞浅动脉-大脑中动脉搭桥术在治疗闭塞性脑血管病中的应用
Application of superficial temporal artery to middle cerebral artery bypass in treatment of cerebral artery steno-occlusive disease
摘要
Abstract
To explore the effect of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in treatment of cerebrovascular disease. Methods: Fifty-two patients with atherosclerotic carotid artery occlusion or middle cerebral artery occlusion or moyamoya disease were included in this study. There were both clinical ischemic manifestation and hemodynamic dysfunction detected by perfusion CT in all the patients. DSA and perfusion CT(PCT) were conducted before and after STA-MCA bypass in order to evaluate the change of hemodynamics and the state of anastomotic astium. The patients were followed-up to know if there was any complication or recurrent stroke. Modified Rankin scale (mRS) was used in assessing the state of neurological function. Results: STA-MCA bypass was performed successfully in 50 patients, while anastomotic astium was found to be obstructed in 2 patients during operation and temporalis attachment was conducted immediately. Complications occurred in 4 patients , 2 with subdural hematoma, 1 with hematoma in contralateral basal ganglia, and 1 with poor wound healing. Postoperative DSA showed that anastomotic astium was opened well in 48 patients, while PCT displayed a significant improvement in both relative cerebral blood flow [ rCBF, (37. 79 ± 9. 76) ml/ (min · 100 g)vs. ( 33.71 ±7. 92)mL/(min · 100 g),P<0.05] and the relative mean transmit time [rMTT,(8.49±1.97)s vs. (11.06 ±3. 00) s,P <0. 01 ]. mRS improved significantly in both the 3 month and 12 month follow-ups(1. 37 ±0. 66 vs. 1. 58 ±0. 64, 0. 84 ±0. 57 vs. 1. 51 ±0. 67,P < 0.05). There was no ipsilateral stroke during the follow-up. Conclusion; STA-MCA bypass may improve the hemodynamic and neurological condition and prevent the recurrence of ischemic stroke in pa-tients combined with occlusive cerebrovascular disease and hemodynamic disturbance.关键词
动脉闭塞性疾病/脑血管重建术/大脑中动脉/颞动脉Key words
Arterial occlusive diseases/ Cerebral revascularization/ Middle cerebral artery/ Temporal arteries分类
医药卫生引用本文复制引用
段鸿洲,李良,张扬,莫大鹏,伊志强,张家湧,鲍圣德..颞浅动脉-大脑中动脉搭桥术在治疗闭塞性脑血管病中的应用[J].北京大学学报（医学版）,2013,45(1):123-128,6.基金项目
高等学校博士学科点专项科研基金(20110001120050)资助 （20110001120050）
