中华脑科疾病与康复杂志（电子版）Issue(5)：19-23,5.DOI:10.3877/cma.j.issn.2095-123X.2014.05.005
颞浅动脉-大脑中动脉搭桥术在缺血性脑血管病中的应用
Application of superficial temporal artery-middle cerebral artery bypass operation in ischemic cerebrovascular diseases
侯晓鹏 1范益民 2刘晓东 1苗旺1
作者信息
- 1. 030001 太原，山西医科大学第一医院神经外科
- 2. 山西省忻州市人民医院神经外科
- 折叠
摘要
Abstract
Objective To explore the therapeutic application of superficial temporal artery-middle cerebral artery( STA-MCA) bypass operation in ischemic cerebrovascular diseases and the value of cerebral CT perfusion imaging ( CTP) on evaluation of preoperative and postoperative cerebral blood flow and surgical results.Methods Eighteen patients undergone STA-MCA bypass surgery in Department of Neurosurgery of the First Hospital of Shanxi Medical University ,from February 2012 to June 2013 were enrolled in this study , with their digital subtraction angiography ( DSA) or CT angiography ( CTA) results showing unilateral vascular occlusion or severe stenosis .CTP was carried out preoperatively to verify whether hemodynamic changes exist or not.After the evaluation of the results of cerebral hemodynamics and clinical manifestations ,patients were selected for STA-MCA bypass operation strictly according to inclusion and exclusion criteria .CTP and DSA or CTA were performed postoperatively .Compared with the preoperative results , the conditions of vascular anastomosis and hemodynamics of surgical patients were evaluated by measuring related indicators .All the patients were followed up and their neurological deficit before and after the operation were evaluated by the National Institute of Health Stroke Scale ( NIHSS ) .All collected data were analyzed by statistical software SPSS 13.0.Results STA-MCA bypass operation was completed successfully in all 18 patients.Postoperative CTP showed ipsilateral cerebral blood flow was significantly increased ( t =-6.443 , P<0.05 ) , the mean transit time decreased markedly(t=6.270,P<0.05),and the time to peak also reduced (t=3.574,P<0.05 ) .The NIHSS scores of 12 weeks after operation decreased ( t=3.310 ,P<0.05 ) ,and their neurological symptoms obviously improved .Conclusion STA-MCA bypass operation could increase the cerebral blood flow of surgical side,alleviate the cerebral blood flow in ischemic region in the short term ,and improve the neurological symptoms of patients suffering from the vascular occlusive disease with hemodynamic changes .To a certain extent ,CTP plays a role in guiding the assessment before and after STA-MCA bypass surgery .关键词
脑缺血/颞浅动脉-大脑中动脉搭桥术/CT灌注成像Key words
Brain ischemia/STA-MCA bypass/CT perfusion imaging引用本文复制引用
侯晓鹏,范益民,刘晓东,苗旺..颞浅动脉-大脑中动脉搭桥术在缺血性脑血管病中的应用[J].中华脑科疾病与康复杂志（电子版）,2014,(5):19-23,5.
